Current and future applications of corneal cross-linking

Khandelwal, Sumitra; Randleman, J. Bradley

doi:10.1097/icu.0000000000000146

Cited by 12 publications

(10 citation statements)

References 72 publications

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“…In the clinic, after crosslinking by UV riboflavin, the presence of a crosslinking boundary in the corneal stroma can be seen under a slit lamp, ASOCT, and a corneal confocal lens. 36 Under the slit lamp, it appears as a gray-white dividing line in the corneal stroma. Under ASOCT, it shows a high-reflective arc-shaped band in the stroma.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Study of Corneal Stroma and Endothelium on Structure and Cells After Genipin Treatment of Rabbit Corneas

Song

Cheng

Yan

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose To study the long-term safety of genipin treatment using a vacuum device with or without epithelial cells at different crosslinking times. Methods Twenty-five healthy New Zealand white rabbits were separated into five treatment groups: 0.25% genipin with epithelial cells for 5 minutes (G1), 0.25% genipin without epithelial cells for 5 minutes (G2), 0.25% genipin without epithelial cells for 10 minutes (G3), ultraviolet A–riboflavin collagen crosslinking (UVA), and controls (C). Before and 2, 4, 6, and 8 weeks after crosslinking treatment, anterior segment optical coherence tomography (ASOCT), in vivo confocal microscopy (IVCM), and the Pentacam system were used to evaluate the right eyes. Results A demarcation line (DL) was observed in the corneal stroma in the G2, G3, and UVA groups. The DL depths in the G2 and G3 groups were stable but decreased in the UVA group over time. The density of keratocytes in these groups increased. Endothelial cell density was decreased in the UVA group. There were no differences in the endothelium before and after treatment in the G1, G2, G3, and C groups. The densitometry, as determined using the Pentacam system, significantly increased in the G2, G3, and UVA groups and was positively correlated with keratocyte densities. Conclusions A vacuum ring assisting local genipin immersion crosslinking without corneal epithelium can activate the keratocytes in the corneal stroma and was safe enough for the thin cornea. Translational Relevance Genipin can not only crosslink the collagen fibers but also activate the keratocytes and even may promote collagen fiber secretion.

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Section: Discussionmentioning

confidence: 99%

Long-Term Study of Corneal Stroma and Endothelium on Structure and Cells After Genipin Treatment of Rabbit Corneas

Song

Cheng

Yan

et al. 2021

Trans. Vis. Sci. Tech.

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“…Čeprav so nove usmeritve vznemitljive, pa so vseeno vse še vedno v zgodnjih fazah. 2 Trenutne raziskave kažejo na zaskrbljujoče povečanje odpornosti očesnih patogenov na pogosto uporabljena protimikrobna zdravila. Ta ugotovitev je že sedaj problematična in bo še bolj v prihodnje, saj so aktualne antibiotične kapljice temelj zdravljenja bakterijskega vnetja roženice.…”

Section: Uvodunclassified

Zdravljenje Okužb Roženice S Prečnim Povezovanjem Kolagenih Vlaken

Silih

2016

SlovMedJour

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Zdravljenje okužb roženice s prečnim povezovanjem kolagenih vlakencorneal collagen cross-linking for infectious keratitis mirna Štabuc Šilih IzvlečekPrečno povezovanje kolagenih vlaken roženice z ultravijolično svetlobo poveča stabilnost roženice z uporabo fotosenzitivne snovi -riboflavina (vitamina B2) in ultravijoličnih žarkov A. Osnovna indikacija je napredujoči keratokonus, poseg pa se v svetu vse pogosteje uporablja. Ker gre pri tem postopku za fiziološke spremembe vsega vezivnega tkiva, so bile predlagane še dodatne indikacije. Te so ektazija po operaciji, bulozna keratopatija in predvsem, najbolj zanimiva, infekcijski keratitis.Okužbe roženice lahko brez ustreznega zdravljenja povzročijo slepoto. Vendar je tudi takojšnje in ustrezno antimikrobno zdravljenje odvisno od senzitivnosti in rezistence mikroorganizmov.Prispevek opisuje sedanje možnosti zdravljenja okužb roženice s prečnim povezovanjem kolagenih vlaken.Ta način zdravljenja bo morda postal pomemben, vendar pa ostajajo odprta še mnoga neodgovorjena vprašanja. Odgovore nanje naj bi dali rezultati večjih, prospektivnih primerjalnih raziskav. AbstractCorneal collagen cross-linking increases the stability of the cornea through the use of the photosensitive material-riboflavin (vitamin B2) and ultraviolet A radiation. Progressive keratoconus is the most common indication and the frequency of these procedures is increasing worldwide. As cross-links in the cornea are a physiological principle of all connective tissues, additional indications were proposed. These include post-refractive surgery ectasia, bullous keratopathy, and, infectious keratitis.Without proper antimicrobial therapy, infectious keratitis can lead to blindness. But even prompt initial management with appropriate antimicrobial treatment depends on microorganism sensitivity and resistance. This article presents current data regarding the use of corneal collagen cross-linking in the treatment of corneal infections. This treatment modality may become important, but unanswered questions remain. Larger, prospective comparative studies should provide the answers. UvodVnetni keratitis lahko brez ustreznega antimikrobnega zdravljenja privede do slepote. Tudi če ga odkrijemo v začetni fazi in pravilno zdravimo, lahko napreduje in privede do mehčanja roženice. Zaradi agresivne narave roženičnih patogenov in nevarnosti odpornosti na antibiotike je potrebno razviti nove načine obvladovanja tega hitro napredujočega stanja.1 O prečnem povezovanju kolagenih vlaken roženice z ultravijolično svetlo-

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“…One of the most important corneal disease is keratoconus (KC), characterized by a progressive thinning and corneal deformation . Some years ago, the only effective therapy for KC was the corneal transplant , today it is possible to treat KC with a new technique: corneal crosslinking (CXL) . This option, however, can be applied only in the early stages of the disease .…”

Section: Introductionmentioning

confidence: 99%

“…Some years ago, the only effective therapy for KC was the corneal transplant , today it is possible to treat KC with a new technique: corneal crosslinking (CXL) . This option, however, can be applied only in the early stages of the disease . To have a device able to detect ultrastructural corneal changes, typical of eyes that will develop KC could help in making earlier diagnosis and to treat these corneas with a less‐invasive therapy like CXL.…”

Section: Introductionmentioning

confidence: 99%

“…To have a device able to detect ultrastructural corneal changes, typical of eyes that will develop KC could help in making earlier diagnosis and to treat these corneas with a less‐invasive therapy like CXL. Moreover, because this type of treatment is very recent and rapidly evolving , to increase information about the corneal modifications could make it possible to improve its effectiveness, modifying some technique aspects or improving the treatment customization.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

In vivo human corneal deformation analysis with a Scheimpflug camera, a critical review

Lanza¹,

Iaccarino²,

Bifani³

2016

Journal of Biophotonics

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Corneal morphological analysis has greatly improved in recent years, providing physicians with new and reliable parameters to study. Moreover, today corneal functional too is a routine analysis, thanks to biomechanical evaluation allowed by an ocular response analyzer (Reichert Ophthalmic Instrument, Depew, NY, USA). Corvis ST (OCULUS Optikgeräte GmbH, Wetzlar, Germany), that relies on the ultrahigh speed Scheimpflug camera, is a new device providing corneal deformation parameters measured ny scanning the cornea response to an air puff; it is an instrument able to measure intraocular pressure too. This device could open up a whole new prospective in screening, detecting and managing corneal diseases, intraocular pressure measurement and in evaluating surgical procedures involving the cornea. This paper provides a comprehensive explanation of Corvis ST measurement principles and parameters and a literature review of scientific studies.

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Current and future applications of corneal cross-linking

Cited by 12 publications

References 72 publications

Long-Term Study of Corneal Stroma and Endothelium on Structure and Cells After Genipin Treatment of Rabbit Corneas

Long-Term Study of Corneal Stroma and Endothelium on Structure and Cells After Genipin Treatment of Rabbit Corneas

Zdravljenje Okužb Roženice S Prečnim Povezovanjem Kolagenih Vlaken

In vivo human corneal deformation analysis with a Scheimpflug camera, a critical review

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