&lt;p&gt;Visual and Refractive Long-Term Outcomes Following Standard Cross-Linking in Progressive Keratoconus Management&lt;/p&gt;

Background: Keratoconus is a condition characterized by biomechanical instability of cornea presenting in a progressive asymmetry and bilateral way. Corneal collagen cross-linking with riboflavin and UVA is a technique that has influenced the treatment of Keratoconus by arresting the progression. Aims and Objectives: The aim of the study was to assess the short-term efficacy and safety of collagen cross-linking in Keratoconus. Materials and Methods: This prospective, nonrandomized, interventional case study was conducted at Aravind Eye hospital and PGI, Puducherry from June 2012 to April 2013. Statistical analysis was done using repeated measures ANOVA and Bonferonn’s using IBM SPSS Inc. 20.Version. Results: A total of 30 patients were enrolled in this study and standard cross linking procedure was done. It was found that UCVA, BSCVA both improved about 40%. Spherical Equivalent reduced by 0.7 D, cylinder reduced by 0.8 D and total astigmatism decreased by about 0.4 D. Steepest K value reduced by 2 D, Irregularity and astigmatism at 3 and 5 mm also changed significantly (P<0.05). Conclusion: Collagen cross-linking arrests the progression of Keratoconus. It seems to improve the UCVA and BCVA and it is a safe and effective procedure.

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“…Our results are also similar to studies done on long-term outcome of C3R. [13][14][15][16] Limitation of the study…”

Section: Discussionsupporting

confidence: 90%

The short term visual, refractive and Topographic outcome of Corneal Collagen Crosslinking in Keratoconus

et al. 2021

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“…In the two-year follow-up following CXL, a significant reduction of the keratometric values as well as a significant improvement of BCVA were observed. Other studies published in the international literature, for example Iqbal et al, show a statistically significant improvement of the Kmax value, albeit with a smaller study cohort (n = 49) [18]. It is worthy of note that, based on the introduction of the Pentacam (Oculus GmbH, Wetzlar, Germany), technological advances are now in use such as differentiated screening programs, for example the Belin/Ambrósio Index, for early recognition of ectatic corneal disorders.…”

Section: Discussionmentioning

confidence: 88%

“…Auch andere Studien in der internationalen Literatur, wie bspw. Iqbal et al, zeigen eine statistisch signifikante Verbesserung des Kmax-Wertes, wenngleich auch mit einer geringeren Studienkohorte (n = 49) [18]. Beachtet werden sollte, dass durch den Fortschritt der Technik mittlerweile auch differenzierte Screeningprogramme, wie bspw.…”

Section: Diskussionunclassified

Successful Regression in Patients with Progressive Keratoconus by Corneal Crosslinking

Röck

Konrad

Röck

et al. 2021

Klin Monbl Augenheilkd

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Background Since 2019, corneal collagen crosslinking (CXL) is included in the catalog of procedures covered by statutory health insurance in Germany. CXL is an established ophthalmological procedure for the last 20 years. The aim of this investigation was the measurement of progression before and after CXL. Material und Methods 65 consecutive eyes with progressive keratoconus from 53 patients were included in the retrospective study, which were observed at the University Eye Hospital Tübingen at least two years before and at least two years after CXL. The time of observation took place from October 2009 until March 2018. Parameters of interest had been the best corrected visual acuity (BCVA) and the keratometric values from the elevation maps measured by a Scheimpflug camera. Results 65 eyes of 53 patients had been documented. The study population included 46 (86.8%) male and 7 (13.2%) female subjects. The mean age was 24 ± 8 years. The averaged observation time between the primary consultation and CXL showed 25 ± 15 months. Preoperatively the mean BCVA pointed out in a significant increase (0.13 ± 0.17 [first visit] vs. 0.23 ± 0.22 [preOP], p < 0.0001) while the mean Kmax resulted in a statistically significant increase (46.34 ± 3.33 dpt [first visit] vs. 48.78 ± 4.17 dpt [preOP], p < 0.0001). The mean thinnest point of the cornea showed a significant decrease (490.48 ± 34.23 µm [first visit] vs. 468.62 ± 29.84 µm [preop], p < 0.0001). Postoperatively the mean BCVA resulted in a significant improvement at the 12th postoperative month in comparison to the preoperative measurement (0.23 ± 0.22 [preOP] vs. 0.16 ± 0.14 [12 months], p = 0.04 respectively 0.17 ± 0.17 [24 months], p = 0.0006). The mean Kmax demonstrated in the 12th postoperative month a significant reduction (48.78 ± 4.17 dpt [preOP] vs. 47.91 ± 3.41 dpt [12 months], p = 0.0009 respectively 48 ± 4.56 dpt [24 months], p = 0.0051). The mean thinnest point of the cornea indicated a decrease at the 12th postoperative month (468.62 ± 29.84 µm [preOP] vs. 459.82 ± 35.88 µm [12 months], p = 0.0078 respectively 453.47 ± 43.39 µm [24 months], p = 0.0227). Conclusion CXL is a successful procedure for the therapy of progressive keratoconus.

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“…In the long term, standard CXL provides good results and reduces the Kmax. Using standard CXL, Iqbal et al 14 reduced keratoconus, with the Kmax varying from 51.95 to 50.19 (p = 0.0001) over a period of 5 years. In a study by Ghanem et al, 15 also with standard CXL, the reduction in Kmax after 2 years was statistically significant (p < 0.001).…”

Section: Discussionmentioning

confidence: 98%

<p>Efficacy of Standard and Accelerated (10 Minutes) Corneal Crosslinking in Keratoconus Stabilization</p>

Stock¹,

Brustollin²,

Mergener³

et al. 2020

OPTH

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Purpose: To evaluate whether Accelerated CXL for 10 minutes is as effective as standard CXL for 30 minutes for the treatment of progressive keratoconus. Patients and Methods: Eighty-two eyes of 62 patients with keratometry examinations performed before and 6 months after surgery were studied. A total of 39 eyes underwent standard CXL with UVA irradiation of 3 mW/cm 2 for 30 minutes and 32 eyes underwent Accelerated CXL UVA irradiation of 9 mW/cm 2 for 10 minutes. The eyes of all patients had corneal thicknesses of at least 450 microns (400 microns after epithelium removal). Results: The means of the keratometry measurements in the preoperative period for the eyes subjected to standard CXL were 46.27 dioptres (D) on the flat axis (K1) and 48.93 D on the steep axis (K2). Postoperatively, K1 was 46.21 D and K2 was 48.97 D, a difference without statistical significance (p = 0.47 and p = 0.48, respectively). In the Accelerated CXL protocol, the preoperative measurements were 44.55 D and 46.19 D for K1 and K2, respectively. In the postoperative period, K1 was 43.37 D, and K2 was 46.64 D (p = 0.38 and p = 0.27, respectively). In the standard group, the mean maximum keratometry (Kmax) preoperatively was 55.87 D, with no statistical significance (p = 0.29). In the preoperative period, the Kmax of the Accelerated group was 51.15 D, with no statistical significance (p = 0.32). Conclusion: Based on the keratometry results, the accelerated protocol was as effective as the standard protocol for keratoconus stabilization.

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<p>Visual and Refractive Long-Term Outcomes Following Standard Cross-Linking in Progressive Keratoconus Management</p>

Cited by 11 publications

References 45 publications

The short term visual, refractive and Topographic outcome of Corneal Collagen Crosslinking in Keratoconus

The short term visual, refractive and Topographic outcome of Corneal Collagen Crosslinking in Keratoconus

Successful Regression in Patients with Progressive Keratoconus by Corneal Crosslinking

<p>Efficacy of Standard and Accelerated (10 Minutes) Corneal Crosslinking in Keratoconus Stabilization</p>

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