Purpose: The purpose of the present study was to assess the long-term efficiency and safety of the "epi-off" accelerated CXL (9 mW/cm for 10 minutes) in comparison to the standard "epi-off" CXL (3 mW/cm for 30 minutes) in terms of topographical and keratometric parameters, refractive data and visual outcomes at 7 years of follow-up, in progressive keratoconus.
Material And Method: A retrospective and comparative study was performed. A total of 183 eyes from 183 patients with documented progressive keratoconus were included in the study. The patients were divided in two groups: 93 eyes from 93 patients underwent "epi-off" standard cross-linking technique (3 mW/cm for 30 minutes) (S-CXL group) and 90 eyes from 90 patients underwent accelerated "epi-off" corneal CXL technique (9 mW/cm for 10 minutes) (A-CXL group).
Results: Improvements in uncorrected distance visual acuity (UDVA) were statistically significant compared to baseline values in both groups at each time-point visit (=0.0421 at 1 year, =0.0411 at 7 years for A-CXL and =0.0375 at 1 year, =0.0389 at 7 years for S-CXL). At 7 years there was a statistically significant increase in CDVA (=0.039 in the A-CXL group and =0.0343 in the S-CXL group at 7 years). Statistically significant reduction was noticed in Ksteep (=0.0411 in A-CXL group and =0.0224 in S-CXL group), Kflat (=0.0198 in A-CXL group and =0.008 in S-CXL group), K mean (=0.0106 in A-CXL group and =0.0193 in S-CXL group) and Kmax (=0.0413 in A-CXL group and =0.054 in S-CXL group) at 7 years, compared to baseline values, in both groups, but without any statistically difference between the two procedures, at all time-point visits (>0.05).
Conclusion: The long-term outcomes of "epi-off" accelerated corneal collagen crosslinking-UVA (9 mW/cm for 10 minutes) are similar to standard "epi-off" corneal collagen crosslinking procedure in the treatment of progressive keratoconus.
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http://dx.doi.org/10.2147/TCRM.S321410 | DOI Listing |
Invest Ophthalmol Vis Sci
November 2024
Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, United States.
Purpose: To quantify corneal cross-linking (CXL)-induced stiffening via mechanical testing to estimate the impact of changes in hydration levels (H) and evaluate depth-dependent tissue hydration after CXL.
Methods: Eighty-three porcine corneal buttons were divided into three groups: Standard protocol CXL (S-CXL), accelerated CXL (A-CXL), and untreated (nonirradiated riboflavin-only) controls. Samples were hydrated or dehydrated to modulate H and dynamic mechanical analyzer compression tests were performed to measure Young's modulus (E).
Exp Eye Res
November 2022
Laboratory for Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland; ELZA Institute, Dietikon, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China; USC Roski Eye Institute, USC Los Angeles, Los Angeles, CA, USA. Electronic address:
Purpose: To evaluate whether repeated application of riboflavin during corneal cross-linking (CXL) has an impact on the corneal biomechanical strength in ex-vivo porcine corneas.
Design: Laboratory investigation.
Methods: Sixty-six porcine corneas with intact epithelium were divided into three groups and analyzed.
Eye (Lond)
April 2023
Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Purpose: Standard corneal collagen cross-linking (S-CXL) is an effective treatment to arrest Keratoconus (KC) progression in children. Less is known on the long-term efficacy of accelerated CXL (A-CXL) in paediatric populations.
Methods: A historical cohort analysis of paediatric patients (≤18 years) with KC who underwent S-CXL and A-CXL at two tertiary referral centres in Israel between 2010-2017.
Purpose: To assess the occurrence of risk factors for progression of keratoconus and failure rate after corneal cross-linking (CXL) in patients with progressive keratoconus.
Methods: This retrospective study observed 230 eyes of 173 patients with a minimum follow-up of 36 months after CXL. A total of 185 eyes underwent CXL once (80%) (control) and 45 (20%) underwent this treatment more than once (Re-CXL-group).
J Ophthalmol
November 2021
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Introduction: Keratoconus is a progressive corneal disease commonly treated by collagen cross-linking (CXL). Accelerated protocols have recently become common. This study sought to compare the outcomes of accelerated and standard CXL in terms of visual acuity, keratometry, and tomographic parameters in pediatric population.
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