Factors affecting visual acuity after accelerated crosslinking in patients with progressive keratoconus

Kirgiz, Ahmet; Atalay, Kürşat; Çabuk, Kübra Şerefoğlu; Kaldırım, Havva; Taşkapili, Mühittin

doi:10.5935/0004-2749.20160046

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…The mean average K decreased in group I & II by (0.216±0.633 and 0.250± 1.665) respectively p=0.261 and 0.619 respectively. These findings were in parallel to those of Ahmet Kırgız et al's study [11] and Paolo Vinciguerra et al's study [12] who showed decrease in the mean average K by (0.13D), (2.74D) respectively p=(0.240) and (<0.05) respectively.…”

Section: Discussionsupporting

confidence: 89%

Objective and Subjective Outcome of Corneal Collagen Crosslinking in Keratoconic Patients According to Keratoconus Grading

Mostafa¹,

Mansour

Helmy³

et al. 2019

The Medical Journal of Cairo University

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Background: Keratoconus is a progressive bilateral disease characterized by corneal thinning. Cross linking is one of the most effective treatments of keratoconus and here we studied its objective and subjective effects. Aim of Study: This study aims to investigate differences in objective and subjective outcome of collagen corneal crosslinking of different keratoconus grades. Patient and Method: Twenty-four eyes of twenty-four patients with keratoconus were enrolled in this prospective study arranged into 2 groups according to k reading (Group I: Less than 48, Group II: 48-52); 12 eyes of patients in each group all the eyes underwent full ophthalmological clinical evaluation (Best Spectacle Corrected Visual Acuity (BSCVA) by log MAR and wave light Pentacam assessment to investigate Keratometry readings, Central Corneal Thickness (CCT), and Aberrations scan by Zernike analysis. Evaluations were done at baseline and 3 months' post CXL. Results: The BCVA insignificantly deteriorated in group I & II after 3 months follow-up by (0.016 ±0.04) p=0.166 and (0.016±0.08) p=0.503 respectively. The mean average K insignificantly decreased in group I & II by (0.216 ±0.63) p=0.261 and (0.250 ± 1.66) p=0.619 respectively. The mean central corneal thickness increased in group I by (11.00 ±31.97) p=0.258 while decreased in group II by (5.750± 16.75) p=0.259. The mean of total aberration of group I decreased by (0.033 ± 0.09) p=0.219, while in group II increased by (0.666 ±0.49) p=0.503. Conclusion: We found insignificant decrease in (BCVA, Average K,) in the two groups the mean CCT increased in group I and decreased in group II. The mean of total aberration decreased in group I while increased in group II.

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Section: Discussionsupporting

confidence: 89%

Objective and Subjective Outcome of Corneal Collagen Crosslinking in Keratoconic Patients According to Keratoconus Grading

Mostafa¹,

Mansour

Helmy³

et al. 2019

The Medical Journal of Cairo University

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“…In the B.ele.Th value, an increase was determined of 1.61µm in the Kmax 0-1 D steepening group and 2.75µm in the >2 D flattening group (Table 3), (Table 4). There have been reports of increased posterior elevation after CXL (21,22). It is suggested that posterior steepening together with anterior flattening may be the cause for the stabilization of keratometric values after CXL (22).…”

Section: Discussionmentioning

confidence: 99%

Progression Analysis With ABCD Grading System Following Corneal Collagen Cross-Linking in Keratoconus

Sağlık¹

2019

Beyoglu Eye J

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To evaluate the ABCD grading system used in follow-up of keratoconus progression after the corneal collagen cross-linking (CXL) treatment in different Kmax groups. Methods: This study included 57 eyes of 43 patients applied with CXL treatment for progressive keratoconus. All the patients were applied with the standard CXL protocol (Dresden). According to the changes in the Kmax value at the end of 12 months postoperatively (0-1D, 1-2D, >2D), the groups were separated as steepening and flattening. Scheimpflug progression parameters, such as ABCD keratoconus grading systems, were evaluated in six different groups. The Paired Samples t-test was used in the evaluation of parameters with normal distribution and the Wilcoxon test for parameters not showing normal distribution. A value of p<0.05 was accepted as statistically significant. Results: Mean age of patients was 18.37±3.86 years (11-28 years). According to the ABCD grading system, 0.19 significant regression was determined in grade A (p=0.014) and 0.24 in grade D (p<0.0001). 0.10 progression was seen in grade B (p=0.089), and 0.11 in grade C (p=0.011). In the mean Kmax value 0.25±0.42, D flattening was seen (p=0.137). Conclusion: The anterior corneal surface grade in ABCD system is correlated with Kmax in different groups. However, the posterior corneal surface parameter is not correlated with Kmax in 1-2 D steepening and >2D flattening groups. Although there is an increase in posterior elevation after CXL, despite excessive Kmax flattening, it would be inaccurate to consider this increase as an indicator of topographic progress.

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“…5 Many studies showed the efficacy of CXL not only in ceasing the progression of keratectasia, but also in flattening the cornea. [6][7][8][9][10][11] While corneal flattening resulted in an improved visual acuity in mild to moderate disease, 12,13 no change in visual function was reported in advanced keratoconus but rather stromal opacities in some cases of thin cornea. [14][15][16] Also, corneal flattening after CXL was correlated with advanced keratoconus, characterized by high preoperative keratometry (above 54.00 D) and thin pachymetry.…”

Section: Introductionmentioning

confidence: 99%

Corneal flattening following collagen crosslinking for keratoconus: Findings at 5-year follow-up

Hoyek

Arej

Rami³

et al. 2020

European Journal of Ophthalmology

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Purpose: To study the corneal flattening effect of cross-linking (CXL) overtime and to look for a potential association with preoperative topographic variables and the central depth of demarcation line (DDL). Methods: 201 eyes of 146 patients (mean age of 31.2 ± 7.3 years) with progressive keratoconus who underwent CXL between June 2007 and December 2012 were enrolled in this retrospective study. Follow-up visits were performed at different time intervals for at least 5 years. Preoperative parameters and depth of demarcation line were collected from LaserVision ophthalmology center in Lebanon. Corneal flattening was defined by a change in postoperative Kmax (ΔKmax) greater than 1.00 D. Results: ΔKmax increased from 50.25% to 61.69%, from first to last follow-up visits. The only factor significantly correlated to ΔKmax during all follow-up visits was preoperative maximum keratometry (Kmax) especially when greater than 50.00 D (OR, 1.92; 95% CI, 1.10–3.34). All eyes showed a corneal demarcation line (mean central depth (DDL): 217.11 ± 26.54 μm), with no statistically significant correlation between DDL and ΔKmax. Conclusion: CXL effect on cornea can be cumulative overtime and delayed flattening occurs in some cases. ΔKmax is positively correlated with preoperative Kmax and no association was found between ΔKmax and DDL. Therefore, DDL may not be a valid measure for the efficacy of CXL.

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Factors affecting visual acuity after accelerated crosslinking in patients with progressive keratoconus

Cited by 15 publications

References 22 publications

Objective and Subjective Outcome of Corneal Collagen Crosslinking in Keratoconic Patients According to Keratoconus Grading

Objective and Subjective Outcome of Corneal Collagen Crosslinking in Keratoconic Patients According to Keratoconus Grading

Progression Analysis With ABCD Grading System Following Corneal Collagen Cross-Linking in Keratoconus

Corneal flattening following collagen crosslinking for keratoconus: Findings at 5-year follow-up

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