Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation
Purpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation. Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2012/498435 |
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| author | Aleksandar Stojanovic Xiangjun Chen Nan Jin Ting Zhang Filip Stojanovic Sten Raeder Tor Paaske Utheim |
| author_facet | Aleksandar Stojanovic Xiangjun Chen Nan Jin Ting Zhang Filip Stojanovic Sten Raeder Tor Paaske Utheim |
| author_sort | Aleksandar Stojanovic |
| collection | DOAJ |
| description | Purpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation.
Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative.
Results. At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max-K at the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrations S 3, 5,7 (𝑃=0.04). Postoperative pain without other complications was recorded.
Conclusion. Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus. |
| format | Article |
| id | doaj-art-d9c2b2b44ff3485caa461a75362475c8 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-d9c2b2b44ff3485caa461a75362475c82025-02-03T00:59:35ZengWileyJournal of Ophthalmology2090-004X2090-00582012-01-01201210.1155/2012/498435498435Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin SaturationAleksandar Stojanovic0Xiangjun Chen1Nan Jin2Ting Zhang3Filip Stojanovic4Sten Raeder5Tor Paaske Utheim6Department of Ophthalmology, University Hospital of North Norway, Fløyvn. 32, Tromsdalen, 9020 Tromsø, NorwaySynsLaser Kirurgi, 9008 Tromsø and 0159 Oslo, NorwaySchool of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical College, Zhejiang, Wenzhou 325003, ChinaSchool of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical College, Zhejiang, Wenzhou 325003, ChinaUniversity of Tromsø, 9037 Tromsø, NorwayDepartment of Ophthalmology, Stavanger University Hospital, 4011 Stavanger, NorwaySynsLaser Kirurgi, 9008 Tromsø and 0159 Oslo, NorwayPurpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation. Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative. Results. At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max-K at the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrations S 3, 5,7 (𝑃=0.04). Postoperative pain without other complications was recorded. Conclusion. Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus.http://dx.doi.org/10.1155/2012/498435 |
| spellingShingle | Aleksandar Stojanovic Xiangjun Chen Nan Jin Ting Zhang Filip Stojanovic Sten Raeder Tor Paaske Utheim Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation Journal of Ophthalmology |
| title | Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation |
| title_full | Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation |
| title_fullStr | Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation |
| title_full_unstemmed | Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation |
| title_short | Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation |
| title_sort | safety and efficacy of epithelium on corneal collagen cross linking using a multifactorial approach to achieve proper stromal riboflavin saturation |
| url | http://dx.doi.org/10.1155/2012/498435 |
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