Journal ArticleDOI
Transepithelial corneal collagen crosslinking for progressive keratoconus: 24-month clinical results
Aldo Caporossi,Cosimo Mazzotta,A. Paradiso,Stefano Baiocchi,Davide Marigliani,Tomaso Caporossi +5 more
TLDR
Functional results after transepithelial CXL showed keratoconus instability, in particular in pediatric patients 18 years old and younger; there was also functional regression in patients between 19 years and 26 years old after 24 months of follow‐up.Abstract:
Purpose To assess the clinical results of transepithelial collagen crosslinking (CXL) in patients 26 years and younger with progressive keratoconus suitable for epithelium-off (epi-off) CXL. Setting Department of Ophthalmology, Siena University Hospital, Siena, Italy. Design Prospective case series. Methods The study included 26 eyes (26 patients) treated by transepithelial (epithelium-on) CXL. The mean age was 22 years (range 11 to 26 years) (10 younger than 18 years; 16 between 19 years and 26 years). Preoperative and postoperative examinations included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, simulated maximum keratometry (K), coma and spherical aberration, and corneal optical coherence tomography optical pachymetry. The solution for transepithelial CXL (Ricrolin TE) comprised riboflavin 0.1%, dextran 15.0%, trometamol (Tris), and ethylenediaminetetraacetic acid. Ultraviolet-A treatment was performed with the Caporossi Baiocchi Mazzotta X Linker Vega at 3 mW/cm 2 . Results After relative improvement in the first 3 to 6 months, the UDVA and CDVA gradually returned to baseline preoperative values. After 12 months of stability, the simulated maximum K value worsened at 24 months. Coma aberration showed no statistically significant change. Spherical aberration increased at 24 months. Pachymetry showed a progressive, statistically significant decrease at 24 months. Fifty percent of pediatric patients were retreated with epi-off CXL due to significant deterioration of all parameters after 12 months of follow-up. Conclusions Functional results after transepithelial CXL showed keratoconus instability, in particular in pediatric patients 18 years old and younger; there was also functional regression in patients between 19 years and 26 years old after 24 months of follow-up. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.read more
Citations
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Journal ArticleDOI
TFOS DEWS II iatrogenic report.
José Álvaro Pereira Gomes,Dimitri T. Azar,Christophe Baudouin,Nathan Efron,Masatoshi Hirayama,Jutta Horwath-Winter,Terry Kim,Jodhbir S. Mehta,Elisabeth M. Messmer,Jay S. Pepose,Virender S Sangwan,Alan L. Weiner,Steven E. Wilson,James S. Wolffsohn +13 more
TL;DR: This report presents future directions to address iatrogenic DED, including the need for more in-depth epidemiological studies about the risk factors, development of less toxic medications and preservatives, as well as new techniques for less invasive eye surgeries.
Journal ArticleDOI
Corneal Collagen Crosslinking: A Systematic Review
Nir Sorkin,David Varssano +1 more
TL;DR: This is a current review of CXL - its biomechanical principles, the evolution of C XL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.
Journal ArticleDOI
Transepithelial Versus Epithelium-off Corneal Cross-linking for the Treatment of Progressive Keratoconus: A Randomized Controlled Trial
TL;DR: It is shown that although transepithelial CXL was a safe procedure without epithelial healing problems, 23% of cases showed a continued keratoconus progression after 1 year, and it is decided not to recommend replacing epi-off CXL by transe Pithelial C XL for treatment of progressive ker atoconus.
Journal ArticleDOI
Treatment options for advanced keratoconus: A review.
TL;DR: A summary of the current and emerging treatment options for advanced KC is offered, aiming to provide the corneal specialist useful information in selecting the optimal therapy for individual patients.
Journal ArticleDOI
In Vivo Confocal Microscopy after Corneal Collagen Crosslinking
Cosimo Mazzotta,Farhad Hafezi,George D. Kymionis,Stefano Caragiuli,Soosan Jacob,Claudio Traversi,Stefano Barabino,J. Bradley Randleman +7 more
TL;DR: In vivo confocal microscopy findings of 84 patients who had undergone conventional epithelium-off corneal collagen crosslinking (CXL) and accelerated CXL (ACXL) were retrospectively reviewed and confirmed that CXL is a safe procedure, which is still undergoing development and protocol adjustments.
References
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Journal ArticleDOI
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