Cross-linking in Progressive Keratoconus Using an Epithelial Debridement or Intrastromal Pocket Technique After Previous Corneal Ring Segment Implantation

Alió, Jorge L.; Toffaha, Bader T; Piñero, David P.; Klonowski, Pawel; Javaloy, Jaime

doi:10.3928/1081597x-20110705-01

Cited by 43 publications

(45 citation statements)

References 18 publications

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“…25 Creation of ring segment channels may be performed with modified femtosecond laser settings, with riboflavin introduced into the channels, though the long terms effects of this combination have not been studied. 3 Options for timing of surgery include simultaneous same-day cross-linking with rings segments or sequential surgery several days apart to several months apart. 89 Both techniques have shown improvement in visual acuity and topography in keratoconus and ectasia.…”

Section: Cross-linking Combined With Intrastromal Corneal Ring Segmentsmentioning

confidence: 99%

Corneal cross-linking

Randleman

Khandelwal

Hafezi

2015

Survey of Ophthalmology

156

113

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Since its inception in the late 1990s, corneal cross-linking has grown from an interesting concept to a primary treatment for corneal ectatic disease worldwide. Using a combination of ultraviolet-A light and a chromophore (vitamin B2, riboflavin), the cornea can be stiffened, usually with a single application, and progressive thinning diseases such as keratoconus arrested. Despite being in clinical use for many years, some of the underlying processes, such as the role of oxygen and the optimal treatment times, are still being worked out. More than a treatment technique, corneal cross-links represent a physiological principle of connective tissue, which may explain the enormous versatility of the method. We highlight the history of corneal cross-linking, the scientific underpinnings of current techniques, evolving clinical treatment parameters, and the use of cross-linking in combination with refractive surgery and for the treatment of infectious keratitis.

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Section: Cross-linking Combined With Intrastromal Corneal Ring Segmentsmentioning

confidence: 99%

Corneal cross-linking

Randleman

Khandelwal

Hafezi

2015

Survey of Ophthalmology

156

113

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“…23 Further, the selection of the exact depth that the riboflavin would be introduced could make the CXL procedure more customized instead of applying UV light and riboflavin to the whole cornea and potentially even at the level of the cornea endothelium. Recently, Alio et al 24 introduced a novel approach for combined ICRS implantation with CXL, where the intrastromal pocket created for ICRS implantationcreated with a femtosecond laser system at a corneal depth ranging from 70 to 90 μm with a 70° side cut and 7 mm diameter-was utilized for riboflavin administration. Riboflavin 0.1% in dextrose was injected directly into the corneal pocket.…”

Section: Simultaneous Treatment With Intracorneal Riboflavin Injectionmentioning

confidence: 99%

Corneal Cross-linking in Combination with Intracorneal Ring Segments

Kılıç¹

2017

International Journal of Keratoconus and Ectatic Corneal Diseases

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The goal of ring segment surgery is to reduce the degree of myopia and astigmatism, improving uncorrected and corrected distance visual acuity. The crosslinking is a procedure used for stabilizing the cornea in patients with progressive keratoconus. Corneal crosslinking surgery and combination of an intracorneal ring segments seems to be as effective for corneal stability and refractive improvement in keratoconic eyes.

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“…[14][15][16] For this reason, new CXL protocols are being developed in order to avoid having to debride the corneal epithelium, such as the creation of intrastromal pockets for riboflavin infusion 17,18 or transepithelial CXL, either iontophoresis-assisted or using a benzalkonium chloride solution to increase the permeability of the corneal epithelium. [19][20][21][22][23][24][25][26][27] Although there is some experimental and clinical evidence of the effectiveness of accelerated transepithelial CXL, it is still limited.…”

Section: -13mentioning

confidence: 99%