Safety and Efficacy of Epithelium-Off Corneal Collagen Cross-Linking for the Treatment of Corneal Ectasia: A Report by the American Academy of Ophthalmology.

Autor:	Cortina MS; Department of Ophthalmology and Visual Science, University of Illinois College of Medicine, Chicago, Illinois., Greiner MA; Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa., Kuo AN; Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina., Li JY; UC Davis Eye Center, University of California, Davis, California., Miller DD; Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida., Shtein RM; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan., Veldman PB; Department of Ophthalmology & Visual Science, The University of Chicago, Chicago, Illinois., Yin J; Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts., Kim SJ; Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee., Shen JF; Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona.
Jazyk:	angličtina
Zdroj:	Ophthalmology [Ophthalmology] 2024 Oct; Vol. 131 (10), pp. 1234-1242. Date of Electronic Publication: 2024 Jun 26.
DOI:	10.1016/j.ophtha.2024.05.006
Abstrakt:	Purpose: To review the evidence on the safety and effectiveness of epithelium-off corneal collagen cross-linking (CXL) for the treatment of progressive corneal ectasia. Methods: A literature search of the PubMed database was most recently conducted in March 2024 with no date restrictions and limited to studies published in English. The search identified 359 citations that were reviewed in abstract form, and 43 of these were reviewed in full text. High-quality randomized clinical trials comparing epithelium-off CXL with conservative treatment in patients who have keratoconus (KCN) and post-refractive surgery ectasia were included. The panel deemed 6 articles to be of sufficient relevance for inclusion, and these were assessed for quality by the panel methodologist; 5 were rated level I, and 1 was rated level II. There were no level III studies. Results: This analysis includes 6 prospective, randomized controlled trials that evaluated the use of epithelium-off CXL to treat progressive KCN (5 studies) and post-laser refractive surgery ectasia (1 study), with a mean postoperative follow-up of 2.4 years (range, 1-5 years). All studies showed a decreased progression rate in treated patients compared with controls. Improvement in the maximum keratometry (Kmax) value, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) was observed in the treatment groups compared with control groups. A decrease in corneal thickness was observed in both groups but was greater in the CXL group. Complications were rare. Conclusions: Epithelium-off CXL is effective in reducing the progression of KCN and post-laser refractive surgery ectasia in most treated patients with an acceptable safety profile. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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