Combined corneal collagen cross-linking and mini asymmetric radial keratotomy for the treatment of keratoconus

Abbondanza, Marco; Abdolrahimzadeh, Barmak; Guidobaldi, Margherita

doi:10.5530/ami.2016.1.14

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…In 1997, the Italian ophthalmologist Lombardi and his associates reported the efficacy of asymmetric radial keratotomy in patients with keratoconus [12]. Later, this approach was further developed so that in 2016 Abbondanza presented the results of a retrospective study on asymmetric radial keratotomy followed by UV-crosslinking; that study indicated the possibility of correcting the refraction abnormalities and stabilizing the keratectatic process [13]. There are additional reports on the efficacy of radial keratotomy in patients with keratoconus [14-16].…”

Section: Introductionmentioning

confidence: 99%

Innovative Technologies in Experimental Corneal Surgery ex vivo

Komarova¹,

Lapshin²,

Burdel³

et al. 2018

Sovrem Tehnol Med

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The aim of the study was to assess the feasibility and outcomes of surgical interventions on the cornea in ex vivo experiments using the Femto Visum femtosecond laser system (Optosystems Ltd., Russia). Materials and Methods. This collective study was conducted by the S. Fyodorov Eye Microsurgery Federal State Institution together with the Scientific-Experimental Production "Eye Microsurgery" Ltd. We have developed a technology for surgical intervention on the cornea with the polymeric intrastromal ring implantation aimed to prevent post-keratoplastic astigmatism. To correct defects of the iris, an original colored gel implant was inserted into the corneal tunnel. With the participation of Optosystems Ltd., we developed an algorithm and related software for using femtolaser keratotomy in the treatment of progressive keratoconus. These interventions were performed with 23 donor (cadaver) eyes that had been earlier rejected for a possible use in human keratoplasty. To assess the feasibility of the posterior lamellar keratoplasty using Femto Visum, we tested the surface quality of the ultrathin grafts prepared from 10 isolated corneal flaps. Results. The proposed keratoplasty technology and the implantation of the intrastromal ring resulted in a complete corneal penetration free from adverse tissue bridges or adhesions. Following the kerato-pigmentation procedure, the gel-colored implant was found stably held in the preformed corneal tunnel; the remaining cornea areas remained intact. The femtolaser-assisted keratotomy resulted in radial incisions at the predetermined locations. According to the roughness parameter, the surface quality of the ultrathin grafts produced with the femtosecond laser assistance was similar to that of the standard samples produced with a mechanical microkeratome. Conclusion. The use of the Femto Visum femtosecond laser system in innovative areas of corneal surgery is effective and safe.

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Section: Introductionmentioning

confidence: 99%

Innovative Technologies in Experimental Corneal Surgery ex vivo

Komarova¹,

Lapshin²,

Burdel³

et al. 2018

Sovrem Tehnol Med

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“…It is not intended, however, as a procedure to correct vision, a condition that has led to its combination with refractive procedures. Successful CXL-combined protocols have been reported with PRK, i-LASIK, ICRS, MARK (6), Phakic Intraocular Lenses (PIOL) and CKP (7). We report the case of a 14-year-old boy with a stage IV keratoconus in both eyes, which has been treated with a combined MARK + CXL intervention, known as the “Rome Protocol”, with a maximum follow-up of over 13 years.…”

Section: Introductionmentioning

confidence: 99%

Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of a Bilateral Stage IV Keratoconus in a 14-year-old Child

Abbondanza¹,

Abbondanza²,

Felice³

2017

Med Arch

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Aim:To present the case of a 14-year-old boy with bilateral stage IV keratoconus, treated with a combined MARK + CXL intervention, without the need for a corneal transplantation.Results:The left eye displays considerable improvements, with a follow-up of 13.5 years: Kmax is decreased by 5.53 D, Kmed is decreased by 1.95 D and thinnest pachymetry is increased by 106 µm. The right eye shows equally remarkable parameters, with a follow-up of 9.5 years: Kmax is decreased by 8.16 D, Kmed is decreased by 0.38 D and thinnest pachymetry is increased by 52 µm. Keratoconus has been halted and the patient has a binocular best corrected visual acuity of -0.079 LogMAR (12/10).Conclusion:The MARK + CXL combined intervention, known as the “Rome Protocol”, was successful in halting a bilateral stage IV keratoconus and improving visual acuity in a very young patient, with long-term follow-up. Conservative treatments should always be privileged when treating very young patients with developed stages of the pathology.

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“…Conservative surgery, aimed at improving vision and/or halting the ectasia in its early stages, include corneal collagen cross-linking (CXL) [2], mini asymmetric radial keratotomy (MARK) [3], circular keratotomy (CK) [4], and implantation of intrastromal corneal ring segments (ICRS) [5]. CXL, the most recent among these, is now widely regarded as the most effective treatment for progressive keratoconus as it directly addresses the intrinsic structural weakness of the cornea by reinforcing the stroma and, thus, stopping the evolution of KC.…”

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confidence: 99%

Peripheral corneal cross-linking (P-CXL) for ultrathin corneas with severe keratoconus: a new technique

Abbondanza¹,

Felice²,

Abbondanza³

2017

Vestn. oftal'mol.

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Corneal cross-linking (CXL) is aimed at halting the progression of keratoconus and is widely considered to be the golden standard in its treatment. It is usually contraindicated, however, in patients with corneal thickness of less than 400 µm, leaving the ophthalmic surgeon no option, but to perform transepithelial CXL (epi-on), usually regarded as less effective. We report a novel approach for ultrathin corneas with severe keratoconus - peripheral corneal cross-linking (P-CXL), in which corneal epithelium is still removed but the apex of the cornea is left untouched. Hypo-osmolar riboflavin solution is used as well. P-CXL was performed on a remarkably developed stage IV keratoconus with the thinnest pachymetry of 215 µm, Kmax of 88.1 D and astigmatism of 11.2 D. Four months after P-CXL, the thinnest pachymetry increased by 42 µm, Kmax decreased by 1.4 D, and astigmatism also decreased by 3.2 D.

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Combined corneal collagen cross-linking and mini asymmetric radial keratotomy for the treatment of keratoconus

Cited by 4 publications

References 7 publications

Innovative Technologies in Experimental Corneal Surgery ex vivo

Innovative Technologies in Experimental Corneal Surgery ex vivo

Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of a Bilateral Stage IV Keratoconus in a 14-year-old Child

Peripheral corneal cross-linking (P-CXL) for ultrathin corneas with severe keratoconus: a new technique

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