Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results
Purpose. To compare functional results in two cohorts of patients undergoing epithelium-off pulsed (pl-ACXL) and continuous light accelerated corneal collagen crosslinking (cl-ACXL) with dextran-free riboflavin solution and high-fluence ultraviolet A irradiation. Design. It is a prospective, compara...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2014/604731 |
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| author | Cosimo Mazzotta Claudio Traversi Anna Lucia Paradiso Maria Eugenia Latronico Miguel Rechichi |
| author_facet | Cosimo Mazzotta Claudio Traversi Anna Lucia Paradiso Maria Eugenia Latronico Miguel Rechichi |
| author_sort | Cosimo Mazzotta |
| collection | DOAJ |
| description | Purpose. To compare functional results in two cohorts of patients undergoing epithelium-off pulsed (pl-ACXL) and continuous light accelerated corneal collagen crosslinking (cl-ACXL) with dextran-free riboflavin solution and high-fluence ultraviolet A irradiation. Design. It is a prospective, comparative, and interventional clinical study. Methods. 20 patients affected by progressive keratoconus were enrolled in the study. 10 eyes of 10 patients underwent an epithelium-off pl-ACXL by the KXL UV-A source (Avedro Inc., Waltham, MS, USA) with 8 minutes (1 sec. on/1 sec. off) of UV-A exposure at 30 mW/cm2 and energy dose of 7.2 J/cm2; 10 eyes of 10 patients underwent an epithelium-off cl-ACXL at 30 mW/cm2 for 4 minutes. Riboflavin 0.1% dextran-free solution was used for a 10-minutes corneal soaking. Patients underwent clinical examination of uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA), corneal topography and aberrometry (CSO EyeTop, Florence, Italy), corneal OCT optical pachymetry (Cirrus OCT, Zeiss Meditec, Jena, Germany), endothelial cells count (I-Conan Non Co Robot), and in vivo scanning laser confocal microscopy (Heidelberg, Germany) at 1, 3, 6, and 12 months of follow-up. Results. Functional results one year after cl-ACXL and pl-ACXL demonstrated keratoconus stability in both groups. Functional outcomes were found to be better in epithelium-off pulsed light accelerated treatment together with showing a deeper stromal penetration. No endothelial damage was recorded during the follow-up in both groups. Conclusions. The study confirmed that oxygen represents the main driver of collagen crosslinking reaction. Pulsed light treatment optimized intraoperative oxygen availability improving postoperative functional outcomes compared with continuous light treatment. |
| format | Article |
| id | doaj-art-22334c10323c41d8b17f335c13b7a535 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-22334c10323c41d8b17f335c13b7a5352025-02-03T01:23:04ZengWileyJournal of Ophthalmology2090-004X2090-00582014-01-01201410.1155/2014/604731604731Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year ResultsCosimo Mazzotta0Claudio Traversi1Anna Lucia Paradiso2Maria Eugenia Latronico3Miguel Rechichi4Ophthalmic Operative Unit, Siena University Hospital, Siena, ItalyOphthalmic Operative Unit, Siena University Hospital, Siena, ItalyOphthalmic Operative Unit, Siena University Hospital, Siena, ItalyOphthalmic Operative Unit, Siena University Hospital, Siena, ItalySanta Lucia Eye Center, Cosenza, ItalyPurpose. To compare functional results in two cohorts of patients undergoing epithelium-off pulsed (pl-ACXL) and continuous light accelerated corneal collagen crosslinking (cl-ACXL) with dextran-free riboflavin solution and high-fluence ultraviolet A irradiation. Design. It is a prospective, comparative, and interventional clinical study. Methods. 20 patients affected by progressive keratoconus were enrolled in the study. 10 eyes of 10 patients underwent an epithelium-off pl-ACXL by the KXL UV-A source (Avedro Inc., Waltham, MS, USA) with 8 minutes (1 sec. on/1 sec. off) of UV-A exposure at 30 mW/cm2 and energy dose of 7.2 J/cm2; 10 eyes of 10 patients underwent an epithelium-off cl-ACXL at 30 mW/cm2 for 4 minutes. Riboflavin 0.1% dextran-free solution was used for a 10-minutes corneal soaking. Patients underwent clinical examination of uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA), corneal topography and aberrometry (CSO EyeTop, Florence, Italy), corneal OCT optical pachymetry (Cirrus OCT, Zeiss Meditec, Jena, Germany), endothelial cells count (I-Conan Non Co Robot), and in vivo scanning laser confocal microscopy (Heidelberg, Germany) at 1, 3, 6, and 12 months of follow-up. Results. Functional results one year after cl-ACXL and pl-ACXL demonstrated keratoconus stability in both groups. Functional outcomes were found to be better in epithelium-off pulsed light accelerated treatment together with showing a deeper stromal penetration. No endothelial damage was recorded during the follow-up in both groups. Conclusions. The study confirmed that oxygen represents the main driver of collagen crosslinking reaction. Pulsed light treatment optimized intraoperative oxygen availability improving postoperative functional outcomes compared with continuous light treatment.http://dx.doi.org/10.1155/2014/604731 |
| spellingShingle | Cosimo Mazzotta Claudio Traversi Anna Lucia Paradiso Maria Eugenia Latronico Miguel Rechichi Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results Journal of Ophthalmology |
| title | Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results |
| title_full | Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results |
| title_fullStr | Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results |
| title_full_unstemmed | Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results |
| title_short | Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results |
| title_sort | pulsed light accelerated crosslinking versus continuous light accelerated crosslinking one year results |
| url | http://dx.doi.org/10.1155/2014/604731 |
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