Transepithelial Corneal Cross-linking With Supplemental Oxygen in Keratoconus: 1-Year Clinical Results
| Autor: | Alex Matthys, Myriam Cassagne, Stéphane Galiacy, François Malecaze, Pierre Fournié, Safa El Hout |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Keratoconus Distance visual acuity Corneal Pachymetry genetic structures Ultraviolet Rays Supplemental oxygen Riboflavin Pilot Projects Endothelial cell count law.invention 03 medical and health sciences 0302 clinical medicine law Ophthalmology Humans Medicine Prospective Studies Dioptre Photosensitizing Agents Corneal Haze Keratoconus 1 Keratometer business.industry Corneal Topography medicine.disease eye diseases Oxygen Cross-Linking Reagents Photochemotherapy 030221 ophthalmology & optometry Surgery Collagen sense organs business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Refractive Surgery. 37:42-48 |
| ISSN: | 1081-597X |
| DOI: | 10.3928/1081597x-20201111-01 |
| Popis: | PURPOSE: To evaluate the efficacy and safety of transepithelial corneal cross-linking (CXL) with supplemental oxygen. METHODS: This was a prospective, non-comparative, pilot cohort study conducted at the National Reference Center for Keratoconus (Toulouse, France) on patients with progressive keratoconus. Transepithelial, pulsed, accelerated CXL was performed in an oxygen-rich atmosphere. Oxygen goggles were applied to the eyes to maintain a high level of oxygen during treatment. The main efficacy outcome was the mean change from baseline in maximum keratometry (Kmax) and the secondary outcomes were the mean changes in flat keratometry (K1), steep keratometry (K2), mean keratometry (Km), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), and demarcation line depth. The safety outcomes were the incidence of adverse events, the mean change in pachymetry, and endothelial cell count. RESULTS: Thirty-four eyes of 34 patients were included. At 12 months postoperatively, the Kmax decreased by 1.56 ± 1.71 diopters (D) ( P < .0001) and CDVA improved by 0.093 ± 0.193 logMAR ( P < .02). The K2 and Km decreased by 0.51 ± 1.03 D ( P < .02) and 0.40 ± 0.78 D ( P < .01), respectively. There was no change in K1 and UDVA. The most frequent adverse event was corneal haze (64.78%). There were neither cases of infectious keratitis or loss of more than two lines in CDVA nor changes in pachymetry or endothelial cell count. CONCLUSIONS: Transepithelial CXL performed in an oxygen-rich atmosphere results in improved Kmax and CDVA with good safety. These promising findings suggest that this procedure could be safe and capable of halting the progression of keratoconus. [ J Refract Surg . 2021;37(1):42–48.] |
| Databáze: | OpenAIRE |
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