The Effectiveness of Corneal Cross-linking in Stopping the Progression of Keratoconus
Authors:
E. Strmeàová 1,2; E. Vlková 1; L. Michalcová 1; V. Trnková 1; D. Dvofiáková 1; M. Goutaib 1; J. Nûmec 1; A. Gerinec 2
Authors place of work:
Oãní klinika LFMU a FN, Brno, pfiednostka
prof. MUDr. Eva Vlková, CSc.
1; Klinika detskej oftalmológie DFNsP
Bratislava, prednosta prof. MUDr.
Anton Gerinec, CSc.
2
Published in the journal:
Čes. a slov. Oftal., 70, 2014, No. 6, p. 218-222
Category:
Original Article
Summary
Objective.
Objective of the study was to prove the efficiency of corneal cross-linking (CXL) in stopping the progression of keratoconus.
Methods.
In this study were included 58 eyes of patients with progressive keratoconus who underwent CXL according to the Dresden protocol in the years 2007-2009 at the Ophthalmic clinic FN Brno Bohunice. The eyes of patients were divided into four groups according to the change of maximum curvature of the cornea two years after CXL.
Results.
Stabilization of maximum curvature of the cornea have been reported in 40 % of eyes, regression in 57 % of eyes by an average of 1,92D and disease progression in 3 % of eyes 2 years after CXL.
The eyes with regression over 2D had significantly higher best-corrected visual acuity before and after the procedure compared to the group with stabilization.
Spherical equivalent increased significantly in all groups, on average, in the group with stabilization of 0,54D, in the group with mild regression of 0,71D and in the group with a large regression of 2,09D. In the group with a large regression 100 % of eyes had stabilization or increase in SE.
Our observations showed that, when a decrease in the patient keratometric values of cornea is present after CXL, it is comprehensive and applies to all parameters.
Conclusion.
We have confirmed that corneal cross-linking stops the progression of the disease in 97 % of eyes two years after the procedure.
Key words:
keratoconus, corneal cross-linking, riboflavin, UVA irradiation, maximum curvature of the cornea, effectivity of the treatment
Zdroje
1. Agrawal, V.,B.: Corneal collagen cross-linking with riboflavin and ultraviolet - a light for keratoconus: results in Indian eyes. Indian J Ophthalmol, 2009; 57(2):111–4.
2. Al-Torbak, A., A., Al-Motowa, S., Al-Assiri, A.,et al.: Deep Anterior Lamellar Keratoplasty for Keratoconus. Cornea, 2006; 25(4): 408–12.
3. Asri, D., Touboul, D., Fournié, P. et al.: Corneal collagen crosslinking in progressive keratoconus: multicenter results from the French National Reference Center for Keratoconus. J Cataract Refract Surg, 2011; 37: 2137–2143.
4. Barraquer, C., Rodriguez-Barraquer, T.: Five-Year Results of Laser In-Situ Keratomileusis (LASIK) After Penetrating Keratoplasty. Cornea, 2004 23(3): 243–8.
5. Brierly, S., C., Izquierdo, Jr. L., Manis, M., J.: Penetrating Keratoplasty for Keratoconus. Cornea, 2000 May; 19(3): 329–32.
6. Coster, D., J., Lowe, M., T., Keane, M.,C., at el.: A comparison of lamellar and penetrating keratoplasty outcomes: a registry study. Ophthalmology, 2014 May;121(5): 979–87.
7. Donnenfeld, E.,D., Kornstein, H.,S., Amin, A. et al.: Laser in situ keratomileusis for correction of myopia and astigmatism after penetrating keratoplasty. Ophthalmology, 1999 Oct;106(10):1966-74; discussion 1974-5,
8. Hersh, P.,S., Greenstein, S.,A., Fry, K.,L.: Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg. 2011 Jan;37(1):149–60.
9. Kanski, J., J., et al.: Clinical ophthalmology, a systenatic approach, sixth edition, Elsevier Butterworth-Heinemann, GB, 2007. ISBN: 078-0-08-045009-4, 288–291.
10. Koller, T., Mrochen, M., Seiler, T.: Complication and failure rates after corneal crosslinking. J Cataract Refract Surg, 2009 Aug;35(8): 1358–62.
11. Koller, T., Pajic, B., Vinciguerra, P. et al.: Flattening of the cornea after collagen crosslinking for keratoconus. J Cataract Refract Surg, 2011 Aug; 37(8): 1488–92.
12. Krachmer, J.,H., Feder, R., S., Belin, M., W. et al.: Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol, 28: 293–322.
13. Kuchyňka, P. et al.: Oční lékařství., Praha, Czech republic: Grada Publishing; 2007. ISBN: 978-80-247-1163-8, 224–225.
14. Lakhani, S.: Keratoconus – Part 3,Contact lens fitting. Optician No. 6077. Vol. 232.
15. Mastropasqua, L., Nubile, M.: Confocal microscopy of the cornea. SLACK Incorporated. 2002, s. 1, 2, 19-27, 65. ISBN 1-55642-611-9.
16. Mazzotta, C., Balestrazzi, A., Traversi, C. et al.: Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans. Cornea, 2007; 26(4): 390–7.
17. Mencucci, R., Marini, M., Paladini, I. et al.: Effects of riboflavin/UVA corneal cross-linking on keratocytes and collagen fibres in human cornea. Clin Experiment Ophthalmol, 2010; 38(1): 49–56.
18. Němcová, I., Pašta, J., Madunický, J.: Léčba keratokonu implantací intrastromálních prstenců. In: Rozsíval et al. In Rozsíval et al. Trendy soudobé oftalmologie 5, 1. vydanie, Praha, Česká republika: Galen; 2008, 84–102.
19. O’Brart, D, P, S: Corneal collagen cross-linking: A review. J Optom. (2014), in press.
20. PiĖero, D., P., Alio, J., L.: Intracorneal ring segments in ectatic corneal disease - a review. Clin Experiment Ophthalmol, 2010; 38(2): 154–67.
21. Rabinowitz, Y.,S.: Keratoconus. Surv Ophthalmol, 1998;42(4): 297–319.
22. Raiskup, F. , Spoerl, E.: Corneal crosslinking with riboflavin and ultraviolet A. I. Principles. Ocul Surf, 2013;11(2): 65–74.
23. Raiskup, F.: Crosslinking pomocou riboflavínu a UVA žiarenia pri ektatických degeneráciách rohovky. In Rozsíval et al. Trendy soudobé oftalmologie 5, 1. vydanie, Praha, Česká republika: Galen; 2008, 62–81.
24. Raiskup-Wolf, F., Hoyer, A., Spoerl, E. et al.: Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg, 2008; 34: 796–801.
25. Roe, R., H., Lass, J., H., Brown, G., C. et al: The Value-Based Medicine Comparative Effectiveness and Cost-Effectiveness of Penetrating, Keratoplasty for Keratoconus. Cornea, 2008; 27(9): 1001–7.
26. Seiler, T., Hafezi, F.: CornealCross-Linking–Induced Stromal Demarcation Line. Cornea, 2006; 25(9): 1057–9.
27. Spoerl, E., Wollensak, G., Seiler. T.: Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res, 2004; 29(1): 35–40.
28. Strmeňová, E., Vlková, E., Hlinomazová, et al.: Corneal cross-linking – moderná metóda liečby keratokónusu. Cesk Slov Oftalmol, 2010; 66(6): 248–53.
29. Sutton, G., Hodge, C., McGhee, C.,N.,J.: Rapid visual recovery after penetrating keratoplasty for keratoconus. Clin Experiment Ophthalmol, 2008; 36(8): 725–30.
30. Vlková E, Hlinomazová Z.: Riziková keratoplastika. Acta facultatis medicinae Universitatis Brunenis Masarykianae 118. 1. vyd., MU Brno 1999, Brno, p. 76.
31. Wollensak, G., Spoerl, E., Seiler, T.: Riboflavin/Ultraviolet-A-induced collagen crosslinking for the treatment of keratococnus. Am J Ophthalmol, 2003; 135: 620–627.
32. Wollensak, G., Wilsch, M., Spoerl, E.: Collagen Fiber Diameter in the Rabbit Cornea after Collagen Crosslinking by Riboflavin/UVA. Cornea, 2004; 23(5): 503–7.
Štítky
OphthalmologyČlánok vyšiel v časopise
Czech and Slovak Ophthalmology
2014 Číslo 6
Najčítanejšie v tomto čísle
- Orbital Complications of Sinusitis
- Actual State of the One Day Simultaneous Bilateral Cataract Surgery Issue
- Diagnostic Pitfalls of Pseudo-Foster Kennedy Syndrome – A Case Report
- The Molecular Genetic and Clinical Findings in two Probands with Stargardt Disease