Corneal Collagen Cross-linking in Advanced Keratoconus: A 4-Year Follow-up Study
Autor: | Marcelo V. Netto, Samir J. Bechara, Marcony R. Santhiago, Andre A.M. Torricelli, Rodrigo França de Espíndola, Natalia T Giacomin, Gustavo K. Marino |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male Keratoconus medicine.medical_specialty Visual acuity genetic structures Adolescent Corneal Pachymetry Ultraviolet Rays Corneal Stroma Riboflavin Corneal collagen cross-linking Visual Acuity Cell Count Refraction Ocular law.invention 03 medical and health sciences Young Adult 0302 clinical medicine law Medicine Humans Corneal pachymetry Retrospective Studies Photosensitizing Agents medicine.diagnostic_test Keratometer business.industry Endothelium Corneal Follow up studies Corneal Topography Retrospective cohort study medicine.disease Corneal topography eye diseases Surgery Ophthalmology Cross-Linking Reagents Photochemotherapy 030221 ophthalmology & optometry Female sense organs Collagen medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
Zdroj: | Journal of refractive surgery (Thorofare, N.J. : 1995). 32(7) |
ISSN: | 1081-597X |
Popis: | PURPOSE: To analyze the safety and efficacy of standard corneal collagen cross-linking (CXL) in advanced cases of progressive keratoconus after 4 years of follow-up. METHODS: A retrospective case series of patients with advanced progressive keratoconus (stages 3 and 4 of Amsler-Krumeich classification) underwent standard CXL treatment. The parameters examined were changes in uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), keratometry values (mean, flat, steep, and apical), pachymetry, and endothelial cell count at the baseline and at 12, 24, and 48 months postoperatively. RESULTS: Forty eyes of 40 patients were enrolled in the study. The mean patient age was 22.5 years (range: 15 to 37 years). Both mean UDVA and CDVA remained stable during the time points; no statistically significant change was noted. Although a slight reduction was observed in all keratometric readings, a statistically significant reduction was only reached in the apical keratometry ( P = .037) at 4 years after CXL. A significant reduction in the corneal thickness was also found (ultrasonic: 388 ± 49 to 379 ± 48 μ m; slit-scanning: 362 ± 48 to 353 ± 51 μ m); however, this change was likely not clinically meaningful. Endothelial cell count was not significantly different at the end of the study. Treatment failure or progression was noted in two patients (5%) over the follow-up period. CONCLUSIONS: Standard CXL treatment was safe and able to stabilize both visual acuity and topographic parameters at 4 years of follow-up in eyes with advanced keratoconus. [ J Refract Surg. 2016;32(7):459–464.] |
Databáze: | OpenAIRE |
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