Objective: to present corneal collagen corsslinking techniques. Corneal collagen cross-linking (CXL) is a procedure used to slow down or arrest the progression of keratoconus in order to avoid or, at least delay the necessity of keratoplasty. CXL means photopolimerisation of the stromal fibrillar tissue, in order to increase their stiffness and resistance to the corneal ectasia. CXL is a process mediated by photo oxidation between an ultraviolet A light and riboflavin.Evidence reviewed: In the 1970s, Siegel et al. presented that crosslinking reactions where lysyl oxidase catalyzed the formation of crosslinking aldehydes in collagen and elastin. The procedure was later developed in 1990 by Theo Seiler who used a UVA light and a photo sensitizer (typically riboflavin) to strengthen bonds in the cornea. Findings: Instruments used in cross-linking: Initial, Wollensak et al., in 2003, used a 370-nm UV light diodes with a potentiometer regulating the voltage, in the present being available: the XLink TM; the CBM Vega XLink Crosslinking System; the LightLink CXL TM; the UV-X TM 2000 Crosslinking System; the KXL TM System. The procedures used today are: Epi-Off Cross-linking technique (standard procedure); CXL with hypo-osmolar riboflavin solution; Epithelium-on CXL technique; Accelerated cross-linking; Iontophoresis Cross-Linking; Contact Lens-Assisted Cross-Linking; LASIK-Xtra; Topography-guided PRK and CXL; Intrastromal Corneal Ring Segments and CXL; Epithelial Island Cross-Linking; Orthokeratology and CXL.The clinical applications of CXL are: corneal ectasia; corneal infections; chemical burns; bullous keratopathy and other causes of corneal edema; LASIK and CXL; PRK and CXL; intra-corneal stromal rings and CXL; scleral CXL (experimental study). Conclusions and relevance:There are no known side effects for the corneal endothelium, lens and retina. Cross-linking treatment does not exclude the possibility of keratoplasty. Cross-linking is a safe and efficient method of treatment in corneal ectasia in order to stop or arrest the progression of conus
Purpose: To establish the importance of ocular biometry in congenital and infantile cataract upon the visual outcomes. Methods:The study was a retrospective study upon patients with congenital and infantile cataract. The study group included 58 eyes from 36 children. For cooperative children, for the ocular biometry we used the OCUSCAN biometer (Alcon, Forth Worth Tx). In very young children we used B-scan ultrasonography to measure the axial length (AXL) of the eye. The target refraction was hyperopia, concording with the age. Results:The measurement of axial length revealed an eye between 20 and above 25 mm. The correlation between axial length and age showed a rapid increase in the first 12 months, a smaller increase between 100-150 months and stabilization after 200 months (statistically significant-medium correlation). The correlation between keratometry and age showed higher values of keratometry at younger children, with a significant decrease in the first 12 months and a smaller rate of decrease after 24 months of age (statistically significant-high correlation). Conclusion:our study shows that the axial length increases during childhood, especially in the first 2 years and the corneal curvature decreases from birth to different ages, parameters which induce the target refraction.
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