Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives

Mastropasqua, Leonardo

doi:10.1186/s40662-015-0030-6

Cited by 89 publications

(71 citation statements)

References 143 publications

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“…Briefly, during this procedure the corneal epithelium is removed and riboflavin eye drops are applied for a pre-defined time-period followed by corneal exposure to ultraviolet A (UVA) light. This induces a photochemical reaction leading to an increase in cross-linking of the extracellular matrix and thereby to an increase in corneal rigidity [75]. Since CXL is used to prevent progression of keratoconus, patients at risk should be identified as early as possible.…”

Section: Discussionmentioning

confidence: 99%

Ultrahigh-resolution OCT imaging of the human cornea

Werkmeister¹,

Sapeta²,

Schmidl³

et al. 2017

Biomed. Opt. Express

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We present imaging of corneal pathologies using optical coherence tomography (OCT) with high resolution. To this end, an ultrahigh-resolution spectral domain OCT (UHR-OCT) system based on a broad bandwidth Ti:sapphire laser is employed. With a central wavelength of 800 nm, the imaging device allows to acquire OCT data at the central, paracentral and peripheral cornea as well as the limbal region with 1.2 µm x 20 µm (axial x lateral) resolution at a rate of 140 000 A-scans/s. Structures of the anterior segment of the eye, not accessible with commercial OCT systems, are visualized. These include corneal nerves, limbal palisades of Vogt as well as several corneal pathologies. Cases such as keratoconus and Fuchs's endothelial dystrophy as well as infectious changes caused by diseases like Acanthamoeba keratitis and scarring after herpetic keratitis are presented. We also demonstrate the applicability of our system to visualize epithelial erosion and intracorneal foreign body after corneal trauma as well as chemical burns. Finally, results after Descemet's membrane endothelial keratoplasty (DMEK) are imaged. These clinical cases show the potential of UHR-OCT to help in clinical decision-making and follow-up. Our results and experience indicate that UHR-OCT of the cornea is a promising technique for the use in clinical practice, but can also help to gain novel insight in the physiology and pathophysiology of the human cornea.

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Section: Discussionmentioning

confidence: 99%

Ultrahigh-resolution OCT imaging of the human cornea

Werkmeister¹,

Sapeta²,

Schmidl³

et al. 2017

Biomed. Opt. Express

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show abstract

“…In recent years, corneal collagen crosslinking (CXL) has gained popularity for the treatment of progressive corneal ectasia 1. CXL has been reported to slow down the rate of progression of corneal ectasia in the setting of keratoconus and pellucid marginal degeneration,2–4 ectasia after laser in situ keratomileusis and photorefractive keratectomy,5 6 ectasia after radial keratotomy7 and ectasia in paediatric populations 8 9.…”

Section: Introductionmentioning

confidence: 99%

Epithelium-off versus transepithelial corneal collagen crosslinking for progressive corneal ectasia: a randomised and controlled trial

Rush

2016

Br J Ophthalmol

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“…Few studies have shown better results with standard 30 minutes irradiation protocol, as recommended by Wollensak et al initially 10,11. However, accelerated CXL has also shown promise, which uses higher irradiance in lesser time to obtain desired results 12. Kir MB et al in their study on 48 eyes showed stabilization of BCVA and corneal topographical indices with irradiance of 45mW/cm2 for two minutes after two years 13.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of transepithelial collagen crosslinking for progressive keratoconus

Ameen¹,

Mehboob²,

Ali³

2016

Pak J Med Sci

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Objective:To evaluate the efficacy and safety of transepithelial (TE) collagen cross-linking (CXL) in patients with progressive keratoconus (KC).Methods:This Quasi Experimental Study was conducted at PNS Shifa Naval Hospital, Karachi from June 2015 to June 2016. Sixty eyes of 32 patients who underwent TE CXL for progressive KC from June 2015 to June 2016 were analysed to ascertain efficacy and safety of TE CXL procedure. Statistical analysis of the data was done using SPSS version 17.0.Results:Twenty eight (87.5%) patients underwent TE CXL bilaterally, while 4 (12.5%) underwent unilateral CXL. Mean change in astigmatism, Maximum simulated Keratometry value (Kmax), Spherical equivalent (SE) and Central Corneal Thickness (CCT) were -0.67±0.35D, 1.28±0.64D, -0.58±0.17D and 0.40±7.58µm respectively, from baseline. Mean gain in lines on Snellen’s visual acuity chart was 1.13±0.83 lines. Changes in astigmatism, Kmax and SE were statistically significant (p<0.001), while change in CCT was not statistically significant. The procedure had excellent safety profile, with no major complication till 6 months follow up period.Conclusion:TE CXL is a safe and effective procedure with statistically significant reduction in corneal astigmatism, Kmax and SE with reasonable gain in Snellen’s visual acuity.

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Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives

Cited by 89 publications

References 143 publications

Ultrahigh-resolution OCT imaging of the human cornea

Ultrahigh-resolution OCT imaging of the human cornea

Epithelium-off versus transepithelial corneal collagen crosslinking for progressive corneal ectasia: a randomised and controlled trial

Efficacy and safety of transepithelial collagen crosslinking for progressive keratoconus

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