Significance of the Lacunar Hydration Pattern After Corneal Cross Linking

Wollensak, Gregor; Herbst, Hermann

doi:10.1097/ico.0b013e3181ca3293

Cited by 37 publications

(33 citation statements)

References 32 publications

(42 reference statements)

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“…This difference in edema pattern between the treated zone and the areas adjacent to it can serve as an explanation for the formation of the above-described demarcation line. By week 6 after the operation, the cellular structure appears to normalize [96]. Others reported the keratocyte loss to be more prolonged - up to 30 months postoperatively [97].…”

Section: Resultsmentioning

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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Section: Resultsmentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

160

122

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“…After collagen cross-linking using riboflavin and UV-A, a lacunar honeycomb-like hydration pattern can be found in the anterior stroma with the maximum cross-linking effect, which is because of the prevention of interfibrillar cross-linking bonds in the positions of the apoptotic keratocytes [25]. The polygonal cross-linking network might contribute favorably to the biomechanical elasticity of the cross-linked cornea and to the demarcation of the anterior stroma after CXL on biomicroscopy [25], thus making lacunar edema a positive sign of efficient cross-linking.…”

Section: Complications Of CXLmentioning

confidence: 99%

Complications of Corneal Collagen Cross-Linking

Dhawan

Rao

Natrajan

2011

Journal of Ophthalmology

161

101

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Cross-linking of corneal collagen (CXL) is a promising approach for the treatment of keratoconus and secondary ectasia. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze, permanent scars, endothelial damage, treatment failure, sterile infiltrates, and herpes reactivation are the other reported complications of this procedure. Cross-linking is a low-invasive procedure with low complication and failure rate but it may have direct or primary complications due to incorrect technique application or incorrect patient's inclusion and indirect or secondary complications related to therapeutic soft contact lens, patient's poor hygiene, and undiagnosed concomitant ocular surface diseases.

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“…The positive effect of CXL on CS was not evident in the early postoperative visit, which might be a consequence of an early temporary anterior stromal haze due to entrapped lacunar edema. 23,24 It has previously been reported that BSCVA and corneal topography indices improve after CXL. 4,7-10 Compared with baseline, we found a progressive improvement of the mean BSCVA over the first year after CXL that remained stable during the second year of follow-up.…”

Section: Discussionmentioning

confidence: 98%