Morphological Modification of the Cornea After Standard and Transepithelial Corneal Cross-linking as Imaged by Anterior Segment Optical Coherence Tomography and Laser Scanning In Vivo Confocal Microscopy

Mastropasqua, Leonardo; Nubile, Mario; Lanzini, Manuela; Calienno, Roberta; Mastropasqua, Rodolfo; Agnifili, Luca; Toto, Lisa

doi:10.1097/ico.0b013e3182844c60

Cited by 52 publications

(42 citation statements)

References 33 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mastropasqua and colleagues compared changes in corneal microstructure in patients with trans epithelial and standard CXL using ICVM. They concluded that microstructural changes visible after CXL are more likely consequence of an inflammatory reaction induced by epithelial injury and the low resolution of in vivo imaging techniques limit the detection of collagen modification induced by CXL treatments [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

et al. 2015

View full text Add to dashboard Cite

Keratoconus is a bilateral and asymmetric corneal ectasia. Cross-linking uses ultra-violate rays to enhance corneal tissue. The purpose of this study was to use in vivo confocal microscopy to quantitatively analyze microstructural changes over time, after corneal collagen cross-linking (CXL) in keratoconus patients. In this before-and-after study, a total of 45 keratoconic eyes were selected for cross-linking among patients referred to Al-Zahra ophthalmology clinic during 2013-2014. All patients underwent complete ophthalmologic examinations. Keratocytes and the present of activated keratocytes were calculated preoperatively and at 1, 3, 6, and 12 months postoperatively using confocal microscopy. One year after CXL, best corrected and best uncorrected visual acuity was increased significantly (p < 0.001). Spherical equivalent and spherical refractive errors reduced significantly (p < 0.001). The reduction in density of anterior and mid-stromal keratocytes was significant initially (p < 0.001). During follow-up, the density of keratocytes increased significantly in all layers reaching near normal values by 12 months. The percentage of activated keratocytes showed a significant increase 1 month after cross-linking (p < 0.001) albeit this percent reduced as the corneal healing proceeded by month 12. The endothelial cells showed no significant reduction during the follow-up. Collagen cross-linking-induced significant reduction in keratocyte density. The percent of activated keratocytes increased significantly after cross-linking which showed reduction with improvement of corneal healing. After collagen cross-linking, hyper-reflective structures were observed consistent with the stromal collagen structures. Further studies are needed to assess possible changes on corneal biomechanics. The consistency in corneal endothelium numbers proves the safety of this technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Shalchi et al 19 recently reported on 45 CXL articles that used an epithelium-off technique and six articles that used a transepithelial technique. However, a meta-analysis could not be performed in this review article because there was only one randomised, controlled clinical trial comparing the two CXL techniques, and this particular trial evaluated only corneal morphological changes on confocal microscopy and optical coherence tomography and did not report corneal topography or visual outcomes 20. Using the published data from the review article of Shalchi et al ,19 we calculated that the mean change in K steep and BSCVA for the 45 articles using an epithelium-off technique were −1.21±1.29 D (range=−6.16 to +1.1) and −0.08±0.07 logMAR (range=−0.23 to +0.06), respectively.…”

Section: Discussionmentioning

confidence: 99%

Epithelium-off versus transepithelial corneal collagen crosslinking for progressive corneal ectasia: a randomised and controlled trial

Rush

2016

Br J Ophthalmol

View full text Add to dashboard Cite

show abstract

“…There were no significant stromal changes (such as a decrease in anterior keratocyte density, evident stromal edema and keratocyte activation) following epi-on CXL. All these changes were significantly evident following epi-off CXL [70]. A study performed on 20 eyes compared epi-off CXL with CXL performed using partial epithelial removal in a grid-like pattern.…”

Section: Evolution Of Riboflavin: Uva Corneal Collagen Crosslinkingmentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

160

122

View full text Add to dashboard Cite

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.

show abstract

Morphological Modification of the Cornea After Standard and Transepithelial Corneal Cross-linking as Imaged by Anterior Segment Optical Coherence Tomography and Laser Scanning In Vivo Confocal Microscopy

Abstract: The preliminary results suggest that traditional CXL induced marked corneal modifications, which were poorly evident in the transepithelial group.

Cited by 52 publications

References 33 publications

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

Comparison of corneal keratocytes before and after corneal collagen cross-linking in keratoconus patients

Epithelium-off versus transepithelial corneal collagen crosslinking for progressive corneal ectasia: a randomised and controlled trial

Corneal Collagen Crosslinking: A Systematic Review

Contact Info

Product

Resources

About