Corneal Wound Healing After Ultraviolet-A/Riboflavin Collagen Cross-Linking: A Rabbit Study

Salomão, Marcella Q.; Chaurasia, Shyam S.; Sinha-Roy, Abhijit; Ambrósio, Renato; Esposito, Andrew C.; Sepulveda, Ricardo N.; Agrawal, Vandana; Wilson, Steven E.

doi:10.3928/1081597x-20101201-02

Cited by 45 publications

(37 citation statements)

References 22 publications

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“…Other surgical insults such as PRK or epithelial debridement can also lead to keratocyte apoptosis but this is usually confined to the more superficial layers (50-75 lm) [19]. Therefore, although some of these changes could be attributed to the epithelial injury but recent ex vivo studies have demonstrated higher rates of keratocyte apoptosis in standard CXL (with epithelial removal) than corneal epithelial removal with either UVA or riboflavin alone [20]. These reports are consistent with our results indicating that CXL has indeed significant impact on corneal stroma and keratocyte apoptosis helping to remodel a firmer microstructure.…”

Section: Discussionmentioning

confidence: 99%

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

et al. 2015

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Keratoconus is a bilateral and asymmetric corneal ectasia. Cross-linking uses ultra-violate rays to enhance corneal tissue. The purpose of this study was to use in vivo confocal microscopy to quantitatively analyze microstructural changes over time, after corneal collagen cross-linking (CXL) in keratoconus patients. In this before-and-after study, a total of 45 keratoconic eyes were selected for cross-linking among patients referred to Al-Zahra ophthalmology clinic during 2013-2014. All patients underwent complete ophthalmologic examinations. Keratocytes and the present of activated keratocytes were calculated preoperatively and at 1, 3, 6, and 12 months postoperatively using confocal microscopy. One year after CXL, best corrected and best uncorrected visual acuity was increased significantly (p < 0.001). Spherical equivalent and spherical refractive errors reduced significantly (p < 0.001). The reduction in density of anterior and mid-stromal keratocytes was significant initially (p < 0.001). During follow-up, the density of keratocytes increased significantly in all layers reaching near normal values by 12 months. The percentage of activated keratocytes showed a significant increase 1 month after cross-linking (p < 0.001) albeit this percent reduced as the corneal healing proceeded by month 12. The endothelial cells showed no significant reduction during the follow-up. Collagen cross-linking-induced significant reduction in keratocyte density. The percent of activated keratocytes increased significantly after cross-linking which showed reduction with improvement of corneal healing. After collagen cross-linking, hyper-reflective structures were observed consistent with the stromal collagen structures. Further studies are needed to assess possible changes on corneal biomechanics. The consistency in corneal endothelium numbers proves the safety of this technique.

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Section: Discussionmentioning

confidence: 99%

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

et al. 2015

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“…The effects of CXL are considered to consist of two phases, first the photochemical reaction and then the wound healing response (Salomao et al 2011;Touboul et al 2012). A corneal demarcation line was seen in a majority of the patients in both treatment groups, as a sign of a crosslinking wound healing response (Seiler & Hafezi 2006).…”

Section: Discussionmentioning

confidence: 99%

Initial results from mechanical compression of the cornea during crosslinking for keratoconus

Rehnman

Behndig

Hallberg

et al. 2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To compare refractive changes after corneal crosslinking with and without mechanical compression of the cornea. Methods: In a prospective, open, randomized case-control study conducted at the Department of Ophthalmology, Ume a University Hospital, Sweden, sixty eyes of 43 patients with progressive keratoconus aged 18-28 years planned for corneal crosslinking and corresponding age-and sex-matched control subjects were included. The patients were randomized to conventional corneal crosslinking (CXL; n = 30) or corneal crosslinking with mechanical compression using a flat rigid contact lens sutured to the cornea during treatment (CRXL; n = 30). Subjective refraction and ETDRS best spectacle-corrected visual acuity (BSCVA), axial length measurement, keratometry and pachymetry were performed before and 1 and 6 months after treatment. Results: The keratoconus patients had poorer BSCVA, higher refractive astigmatism and higher keratometry readings than the control subjects at baseline (p < 0.01). In the CXL group, BSCVA increased from 0.19 AE 0.26 to 0.14 AE 0.18 logMar (p = 0.03), and the spherical equivalent improved from À1.9 AE 2.8 D to À1.4 AE 2.4 D (p = 0.03). Maximum keratometry readings decreased after CXL from 53.1 AE 4.9 D to 52.6 AE 5.2 D (p = 0.02), and the axial length decreased in the CXL group, likely due to post-treatment corneal thinning (p = 0.03). In the CRXL group, all the above variables were unaltered (p > 0.05). Conclusion: At 6 months, the refractive results from CRXL did not surpass those of conventional CXL treatment. Rather, some variables indicated a slightly inferior effect. Possibly, stronger crosslinking would be necessary to stabilize the cornea in the flattened configuration achieved by the rigid contact lens.

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“…Although the section "Translational Science" is new, the Journal has published a number of articles in past years that would have been ideal candidates for such a section. [6][7][8][9][10][11] The inaugural Translational Science article in this month's issue is from Santhiago and colleagues on short-term cell death and infl ammation after intracorneal inlay implantation in rabbits. 12 Although not all scientists are in agreement with the promotion of this term, the Journal aims to provide different outlooks and modern usage of translational research in this way to advance the fi eld of refractive surgery.…”

Section: Discussionmentioning

confidence: 99%

The Increasing Importance of Translational Vision Research in Refractive Surgery

Hafezi¹,

Kristoffersen-Hafezi²

2012

J Refract Surg

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Corneal Wound Healing After Ultraviolet-A/Riboflavin Collagen Cross-Linking: A Rabbit Study

Cited by 45 publications

References 22 publications

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

Initial results from mechanical compression of the cornea during crosslinking for keratoconus

The Increasing Importance of Translational Vision Research in Refractive Surgery

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