Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of a Bilateral Stage IV Keratoconus in a 14-year-old Child

Abbondanza, Marco; Abbondanza, Gabriele; Felice, Valentina De

doi:10.5455/medarh.2017.71.69-71

Cited by 5 publications

(3 citation statements)

References 9 publications

(7 reference statements)

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“…The last option in management too thin cornea is completely replacing the all layer (penetrating keratoplasty) or partial layers (lamellar keratoplasty) with new healthy donor tissue (5) . Some studies reported that exposure of guinea pigs to ultraviolet rays A develops nuclear cataract (6) .…”

Section: Introductionmentioning

confidence: 99%

Effect of corneal collagen cross linking on crystalline lens clarity graded by Pentacam Nucleus Staging Software

Fahmy

Barrada

Khalil

2023

Preprint

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Background to describe the effect of ultraviolet rays dissipated during corneal collagen crosslinking on cataract development in keratoconus patient in Cairo, Egypt. Methods We performed a descriptive prospective study that will assess the influence of uneventful corneal collagen crosslinking in management of keratoconus on the crystalline lens clarity in one hundred Eye by oculus pentacam nucleus staging (PNS) for patients attending the specialist eye hospital at the military medical complex of Kobri el Kobba in collaboration with Al-Azhar university hospitals diagnosed from January 2021. Results Our study reported that corneal collagen crosslinking has a highly significant effect in developing lens opacities specially the older age and small AC depth and reported also its affection on visual acuity. Conclusion Corneal collagen cross linking as a method of stabilizing keratoconus progression results in significant changes and increase in the densitometry of the crystalline lens which is a problem that increase the risk in the development of cataract, this is particularly in patient more exposed to ultraviolet rays and pre CXL high lens densitometry.

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Section: Introductionmentioning

confidence: 99%

Effect of corneal collagen cross linking on crystalline lens clarity graded by Pentacam Nucleus Staging Software

Fahmy

Barrada

Khalil

2023

Preprint

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“…According to recent literature, the prevalence and annual incidence of KC are 1:375 and 1:7,500, respectively, which are five- to tenfold higher than those in previous report [2]. Although many established therapies, such as rigid gas-permeable contact lenses and corneal transplantation, are effective in improving KC patient vision, corneal cross-linking (CXL) was the only minimally invasive treatment to improve corneal biomechanical property and halt the progression of KC [3–5].…”

Section: Introductionmentioning

confidence: 99%

Whether Keratectasia Area Shown in Corneal Topography Is Appropriate for Evaluating the Effect of Corneal Cross-Linking for Keratoconus: A 12-Month Follow-Up Study

Wang

Zhang

et al. 2019

BioMed Research International

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Purpose. To analyze the keratectasia area (KEA) shown in corneal topography before and after corneal cross-linking (CXL) in patients with progressive keratoconus (KC) and figure out whether KEA is appropriate for evaluating the effect of CXL. Methods. A retrospective analysis was conducted in 34 eyes from 24 progressive KC patients who have underwent CXL from 2015 to 2017. Area with K-value more than 47D shown in the corneal topography was marked and identified as KEA. Keratometry (K1, K2, and Kmax), KEA, thinnest corneal thickness (TCT), and endothelial cell density (ECD) were evaluated preoperatively or at months 3, 6, and 12 postoperatively. The changes of KEA before and after operation were evaluated. The relation of KEA and other parameters, including Kmax and TCT, was analyzed. Results. Linear regression model revealed the KEA, Kmax, K1, and K2 decreased after CXL in model y = 0.9622 -0.02408 x (P<0.05), y = 0.9982 -0.003469 x(P<0.05), y = 0.9977 + -0.001347 x(P<0.05), y = 0.9992 + -0.001779 x(P<0.05) (y represents KEA, Kmax, K1, or K2; x represents time (month)). The KEA is significantly decreased in early stage (before month 3) (P<0.05); however, the Kmax, K1, and K2 have no significant decrease in early stage (P= 0.09, 0.19, 0.32). Conclusions. The KEA is more sensitive than K-value in describing the morphological changes of cornea after CXL, especially in early stage after treatment.

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“…Apart from a slight degree of corneal flattening with the ‘epi-off’ (Dresden protocol) technique, however, it does not significantly improve a patient's visual acuity [14], a condition that has led to a number of CXL-combined procedures. Combined protocols discussed in the medical literature include CXL paired with photorefractive keratectomy (PRK) (Athens protocol) [15], femtosecond laser-assisted in situ keratomileusis (FemtoLASIK) [16], ICRS [17], phakic intraocular lenses [18], CKP [19], and MARK [20]. The latter combined intervention, the ‘Rome protocol,’ was the focus of this study, the aim of which was to investigate the effectiveness of this protocol for disease stabilization and improvement of visual acuity based on long-term follow-up data.…”

mentioning

confidence: 99%

Long-term Results of Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of Keratoconus

Abbondanza

Felice

et al. 2019

Korean J Ophthalmol

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Purpose To investigate the long-term results (at least 5 years of follow-up) of the mini asymmetric radial keratotomy (MARK) and corneal cross-linking (CXL) combined intervention, also known as the ‘Rome protocol,’ for patients with progressive stage I and II keratoconus and contact lens intolerance. Methods This was a retrospective observational case series. Fifteen eyes of 12 patients were evaluated, with a mean follow-up of 6.9 years. To assess the efficacy and stability of the MARK + CXL combined protocol, best spectacle-corrected visual acuity, mean pachymetry, and mean keratometry were recorded preoperatively and at least 1, 3, and 5 years postoperatively. Statistical analysis was performed using the R platform and involved the Wilcoxon signed-rank and Kruskal-Wallis non-parametric tests. Results Best spectacle-corrected visual acuity improved for all patients, from 0.46 ± 0.69 logarithm of the minimum angle of resolution (20 / 60) to 0.15 ± 0.69 logarithm of the minimum angle of resolution (20 / 30, p = 0.0006), while mean pachymetry increased in 93% of patients, from 442.80 ± 61.02 to 464.50 ± 62.72 µm ( p = 0.003). Lastly, mean keratometry improved in 87% of patients after 6.9 years of observation from 48.82 ± 5.00 to 43.25 ± 3.58 diopters ( p = 0.008). No intraoperative or postoperative complications were observed. Conclusions The MARK + CXL combined protocol was effective in treating keratoconus by halting corneal thinning and bulging. In addition, this procedure significantly improved visual acuity based on long-term follow-up data. Analysis of data from a larger cohort of patients would be useful to support these findings.

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Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of a Bilateral Stage IV Keratoconus in a 14-year-old Child

Cited by 5 publications

References 9 publications

Effect of corneal collagen cross linking on crystalline lens clarity graded by Pentacam Nucleus Staging Software

Effect of corneal collagen cross linking on crystalline lens clarity graded by Pentacam Nucleus Staging Software

Whether Keratectasia Area Shown in Corneal Topography Is Appropriate for Evaluating the Effect of Corneal Cross-Linking for Keratoconus: A 12-Month Follow-Up Study

Long-term Results of Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of Keratoconus

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