Intrastromal crosslinking in post-LASIK ectasia

Moscovici, Bernardo Kaplan; Campos, Mauro

doi:10.5935/0004-2749.20140049

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…The one eye was treated with what was termed intrastromal CXL, and ended up asymptomatic with 20/20 acuity and no sign of disease progression on corneal topography after 1 year 28. In contrast to our study, the flap was only opened, and riboflavin was injected between the flap and the stroma bed.…”

Section: Discussionmentioning

confidence: 67%

“…To our knowledge, the only report similar to this technique for early PLE is the case of a 28-year-old female who presented 4 months post-LASIK with unilateral inferior corneal steepening and decreased visual acuity 28. The one eye was treated with what was termed intrastromal CXL, and ended up asymptomatic with 20/20 acuity and no sign of disease progression on corneal topography after 1 year 28.…”

Section: Discussionmentioning

confidence: 99%

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Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique

Wallerstein¹,

Adiguzel²,

Gauvin³

et al. 2016

OPTH

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PurposeCollagen cross-linking (CXL) for post-laser-assisted in situ keratomileusis (LASIK) ectasia (PLE) is traditionally performed either epi-on or epi-off on the corneal surface. This study describes a novel technique in treating early PLE with under-flap CXL (ufCXL) to the stromal bed and reports on 6-month outcomes.Patients and methodsCase series of seven patients (eight eyes) with topography-diagnosed early PLE treated with ufCXL. Inclusion criteria were early, mild PLE defined as new-onset postoperative manifest refraction cylinder ≤1.50 D, with new topographic inferior steepening consistent with ectasia, uncorrected distance visual acuity (UDVA) of 20/40 or better, and corrected distance visual acuity (CDVA) of 20/25 or better. Existing LASIK flap was lifted, riboflavin was applied directly to the stromal bed, flap was repositioned, and 18 mW/cm2 ultraviolet light was applied for 3 minutes to the corneal surface. Post-ufCXL manifest refraction, UDVA and CDVA, corneal cylinder, Kmax, and corneal irregularity index were compared with pre-ufCXL measurements.ResultsPatients had a pre-ufCXL sphere of 0.09±0.48 D and cylinder of −0.78±0.49 D. At 6 months, post-ufCXL sphere (0.06±0.8 D; P=0.89) and cylinder (−1.09±0.76 D, P=0.26) were unchanged. Cumulative post-ufCXL UDVA was unchanged, achieving 20/20, 20/30, and 20/40 in 25%, 88%, and 88%, respectively, compared with 13%, 63%, and 88% pre-ufCXL (P=0.68). Post-ufCXL CDVA was unchanged (P=0.93) with a gain of one line in two eyes, a loss of one line in one eye, and five eyes unchanged. The efficacy index (P=0.76), safety index (P=0.89), Kmax (P=0.94), and corneal irregularity index (P=0.73) were also unchanged.ConclusionPreliminary results with ufCXL for early PLE are promising, demonstrating maintenance of visual accuracy, efficacy, safety, Kmax, and cylinder, with much quicker recovery times than surface CXL.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique

Wallerstein¹,

Adiguzel²,

Gauvin³

et al. 2016

OPTH

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“…Ectasia is one of the most common post-LASIK complications. In most cases, crosslinking is considered the gold standard to prevent progression (3) . Severe cases with acute hydrops in post-LASIK ectasia patients are also common (2,4) ; however, to our knowledge, no studies have discussed aqueous leakage in these cases.…”

Section: Discussionmentioning

confidence: 99%

“…Although the complication rate is low (0.04%-0.6%), the number of cases reported might be underestimated (2) . The main risk factors include suspected preoperative topographical abnormalities, residual stromal bed <250 µm, preoperative corneal thickness less than normal, and increased myopia (3) . Currently, one of the most important parameters used in preoperative evaluations for LASIK is the percentage of tissue altered (PTA) >40% ([flap thickness + ablation depth]/central corneal thickness) (2) .…”

Section: Introductionmentioning

confidence: 99%

Sutura corneana em hidrópsia aguda secundária à ectasia pós LASIK: relato de caso

Diniz¹,

Andrade²,

Chamon³

et al. 2020

Arquivos Brasileiros De Oftalmologia

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“…7 Performing CXL under the LASIK flap (flap-CXL) has been proposed to stabilize post-LASIK ectasia. [8][9][10] Instead of corneal debridement as in Standard CXL, the existing flap is reflected, with riboflavin applied directly onto the stromal bed followed by flap repositioning and UVA irradiation. This technique bears similarities to LASIK with simultaneous prophylactic CXL under the flap, which has been purported to potentially reduce the risk of regression or the development of ectasia, 11 but which has uncertain clinical and biomechanical benefit.…”

mentioning

confidence: 99%

Brillouin microscopic depth-dependent analysis of corneal crosslinking performed over or under the LASIK flap

Zhang

Roozbahani

Piccinini

et al. 2020

J Cataract Refract Surg

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Intrastromal crosslinking in post-LASIK ectasia

Cited by 6 publications

References 10 publications

Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique

Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique

Sutura corneana em hidrópsia aguda secundária à ectasia pós LASIK: relato de caso

Brillouin microscopic depth-dependent analysis of corneal crosslinking performed over or under the LASIK flap

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