Effect of Corneal Collagen Cross-Linking on Corneal Innervation, Corneal Sensitivity, and Tear Function of Patients with Keratoconus

Kontadakis, Georgios A.; Kymionis, George D.; Kankariya, Vardhaman P.; Pallikaris, Aristofanis I.

doi:10.1016/j.ophtha.2012.10.012

Cited by 32 publications

(22 citation statements)

References 39 publications

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“…The results suggest that even without deepithelialization, pain or discomfort may be attributed to apoptosis of keratocytes and damage of anterior stromal nerve fibers caused by toxic effects of CXL, as reported in several studies [6, 30, 37]. Corneal denervation could theoretically generate dry eye-related problems due to the decreased blinking rate and increased tear evaporation and exposure of corneal surface.…”

Section: Discussionsupporting

confidence: 60%

Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

Stojanović

Zhou²,

Utheim

2014

BioMed Research International

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Purpose. Our main purpose was to compare safety and efficacy in the treatment of progressive keratoconus with “epithelium-on” and “epithelium-off” corneal collagen cross-linking (CXL). Our secondary purpose was to evaluate efficacy of CXL when hypotonic 0.5% riboflavin is used as photosensitizer. Methods. One eye of 20 patients with bilateral progressive keratoconus was randomly treated for “epithelium-on” CXL (group 1) while the fellow eye underwent “epithelium-off” CXL (group 2). Hypotonic 0.5% riboflavin was used in both groups. Visual acuity, refraction, corneal topography, and wavefront aberrometry were evaluated at baseline and after 1, 6, and 12 months. Specular microscopy was performed on 10 patients preoperatively and after 12 months. Postoperative pain was evaluated using a patient questionnaire. Results. Uncorrected and corrected distance visual acuity improved significantly in both groups. Refraction, topography, and aberrometry showed nonsignificant changes from the preoperative status throughout the 12-month follow-up in both groups. Moreover, the outcomes between the groups were comparable at all follow-up points. Endothelial cell-count was stable. Postoperative pain length was shorter in group 1 (P < 0.001). Conclusion. “Epithelium-on” and “epithelium-off” CXL using hypotonic 0.5% riboflavin were equally safe and effective in stabilization of keratoconus. Topography and aberrometry outcomes in both groups failed to show any significant improvements. This study is registered at ClinicalTrials.gov: NCT01181219.

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Section: Discussionsupporting

confidence: 60%

Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

Stojanović

Zhou²,

Utheim

2014

BioMed Research International

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“…Our results, similar to those in other studies, 14,15,27 showed an initial reduction in corneal sensitivity after epi-off CXL and a recovery of sensitivity during the 6-month follow-up. Although corneal sensitivity during the 7 days after epi-off CXL was significantly lower than after epi-on CXL, after the epi-on treatment the cornea was significantly less sensitive than it was preoperatively.…”

Section: Discussionsupporting

confidence: 92%

“…Two recent studies reported transient hypoesthesia in keratoconic corneas 6 to 9 months after epi-off CXL. 14,15 To our knowledge, to date there have been no published studies of corneal sensitivity after epi-on CXL. This study evaluated corneal sensitivity in keratoconic eyes following epion and epi-off CXL.…”

Section: Resultsmentioning

confidence: 99%

Recovery of corneal sensitivity after collagen crosslinking with and without epithelial debridement in eyes with keratoconus

Spadea

Salvatore

Paroli

2015

Journal of Cataract and Refractive Surgery

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“…Following CXL, corneal sensitivity has been shown to significantly decrease and gradually recover during the first 6 postoperative months [185,186]. No effect on tear secretion or tear film stability was observed [186].…”

Section: Safetymentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

160

122

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Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.

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Effect of Corneal Collagen Cross-Linking on Corneal Innervation, Corneal Sensitivity, and Tear Function of Patients with Keratoconus

Cited by 32 publications

References 39 publications

Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

Recovery of corneal sensitivity after collagen crosslinking with and without epithelial debridement in eyes with keratoconus

Corneal Collagen Crosslinking: A Systematic Review

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