Transient Corneal Thinning in Eyes Undergoing Corneal Cross-Linking

Holopainen, Juha M.; Krootila, Kari

doi:10.1016/j.ajo.2011.03.023

Cited by 96 publications

(75 citation statements)

References 14 publications

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“…However, additional thinning of corneas thicker than 400 μm can take place during the CXL procedure itself, causing them to become less than 400 μm thick during the course of the procedure. A reduction in thickness of 75-87 μm during different stages of the CXL procedure has been demonstrated [200,201]. This transient thinning can be related either to evaporation through the deepithelized surface or to the oncotic effect of 20% dextran used to form an isoosmolar riboflavin solution.…”

Section: Safetymentioning

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: Safetymentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

160

122

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“…We did not observe any serious complication mentioned above in our study. We noted that there was statistically significant transient decrement in the ECD at the 1st month,3m and 12m as previously reported [15,16]. The number of the patients, short follow up duration and lack of comparison between conventional CXL method and accelerated CXL method were limitations of our study.…”

mentioning

confidence: 49%

Effect Of Accelerated Corneal Collagen Cross Linking (CXL) On Corneal Endothelium

Bh¹,

ari²,

Lohia³

et al. 2015

AOVS

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“…Epithelial remodeling, anatomic and structural changes in corneal collagen fibrils (9,18) , and keratocyte apoptosis (13) , might be also implicated. A temporary increase in endothelial pump activity that may be caused by UVA exposure has been also suggested as a cause of the initial corneal thinning after CXL (17) . Surgeons must be aware about the intraoperative and postoperative thinning of the cornea after CXL, especially in thinner corneas (less than 400 μm).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, this finding was not related to complications in this series of patients. However, as previously suggested (10,17) , the application of hypo-osmolar riboflavin solution should be continued during the entire process of irradiation to sustain the necessary concentration of the solution and to avoid any desiccation of the cornea.…”

Section: Discussionmentioning

confidence: 99%

Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

Nassaralla¹,

Vieira

Machado

et al. 2013

Arq. Bras. Oftalmol.

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Purpose: To evaluate the thinnest corneal thickness changes during and after corneal collagen cross-linking treatment with ultraviolet-A irradiation, using hypo-osmolar riboflavin solution in thin corneas. Methods: Eighteen eyes of 18 patients were included in this study. After epithelium removal, iso-osmolar 0.1% riboflavin solution was instilled to the cornea every 3 minutes for 30 minutes. Hypo-osmolar 0.1% riboflavin solution was then applied every 20 seconds for 5 minutes or until the thinnest corneal thickness reached 400 µm. Ultraviolet-A irradiation was performed for 30 minutes. During irradiation, iso-osmolar 0.1% riboflavin drops were applied every 5 minutes. Ultrasound pachymetry was performed at approximately the thinnest point of the cornea preoperatively, after epithelial removal, after iso-osmolar riboflavin instillation, after hypo-osmolar riboflavin instillation, after ultraviolet-A irradiation, and at 1, 6 and 12 months after treatment. Results: Mean preoperative thinnest corneal thickness was 380 ± 11 µm. After epithelial removal it decreased to 341 ± 11 µm, and after 30 minutes of iso-osmolar 0.1% riboflavin drops, to 330 ± 7.6 µm. After hypo-osmolar 0.1% riboflavin drops, mean thinnest corneal thickness increased to 418 ± 11 µm. After UVA irradiation, it was 384 ± 10 µm. At 1, 6 and 12 months after treatment, it was 372 ± 10 µm, 381 ± 12.7, and 379 ± 15 µm, respectively. No intraoperative, early postoperative, or late postoperative complications were noted. Conclusions: Hypo-osmolar 0.1% riboflavin solution seems to be effective for swelling thin corneas. The swelling effect is transient and short acting. Corneal thickness should be monitored throughout the procedure. Larger sample sizes and longer follow-up are required in order to make meaningful conclusions regarding safety.

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Transient Corneal Thinning in Eyes Undergoing Corneal Cross-Linking

Cited by 96 publications

References 14 publications

Corneal Collagen Crosslinking: A Systematic Review

Corneal Collagen Crosslinking: A Systematic Review

Effect Of Accelerated Corneal Collagen Cross Linking (CXL) On Corneal Endothelium

Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

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