Muhammet Bahattin Kır1, Kemal Türkyılmaz2, Veysi Öner2. 1. a Department of Ophthalmology , Kars Harakani State Hospital , Kars , Turkey. 2. b Department of Ophthalmology , Recep Tayyip Erdoğan University Medical School , Rize , Turkey.
Abstract
PURPOSE: To report 2-year outcomes of transepithelial high-intensity cross-linking (CXL) procedure in the treatment of patients with progressive keratoconus. METHODS: Forty-eight eyes of 48 consecutive progressive keratoconus patients who underwent transepithelial accelerated CXL procedure were enrolled in the study. Each patient underwent pre- and postoperative comprehensive ophthalmologic examinations including determination of refractive error as spherical equivalent (SE) and corrected distant visual acuity (CDVA), slit lamp biomicroscopic examination, fundoscopy, and a detailed analysis on a Scheimplug+Placido device (Sirius, CSO, Florence, Italy). The riboflavin solution, which was composed of riboflavin 0.25% with hydroxypropyl methylcellulose (HPMC) and benzalkonium chloride (BAC) (ParaCel, Avedro), was used in the procedure. The cornea was exposed to ultraviolet A light (KXL System, Avedro Inc., Waltham, MS, USA) for 2 minutes and 40 seconds at an irradiance of 45 mW/cm2. RESULTS: The mean age of the patients was 25.9 ± 4.0 (ranging from 18 to 33) years. No significant changes were observed in the mean CDVA, SE, and topographic indices at year 1 and year 2 visits compared to preoperative examination. The mean corneal thickness at the thinnest point was significantly higher at year 1 and year 2 visits than at preoperative examination (p1 = 0.014 and p2 = 0.017, respectively). No intra- or postoperative complications or adverse reactions were observed. CONCLUSIONS: Transepithelial high-intensity (irradiance of 45 mW/cm2 for 2 minutes and 40 seconds) CXL using 0.25% riboflavin solution was a safe and effective method to halt the progression of keratoconus for a 2-year follow-up period.
PURPOSE: To report 2-year outcomes of transepithelial high-intensity cross-linking (CXL) procedure in the treatment of patients with progressive keratoconus. METHODS: Forty-eight eyes of 48 consecutive progressive keratoconus patients who underwent transepithelial accelerated CXL procedure were enrolled in the study. Each patient underwent pre- and postoperative comprehensive ophthalmologic examinations including determination of refractive error as spherical equivalent (SE) and corrected distant visual acuity (CDVA), slit lamp biomicroscopic examination, fundoscopy, and a detailed analysis on a Scheimplug+Placido device (Sirius, CSO, Florence, Italy). The riboflavin solution, which was composed of riboflavin 0.25% with hydroxypropyl methylcellulose (HPMC) and benzalkonium chloride (BAC) (ParaCel, Avedro), was used in the procedure. The cornea was exposed to ultraviolet A light (KXL System, Avedro Inc., Waltham, MS, USA) for 2 minutes and 40 seconds at an irradiance of 45 mW/cm2. RESULTS: The mean age of the patients was 25.9 ± 4.0 (ranging from 18 to 33) years. No significant changes were observed in the mean CDVA, SE, and topographic indices at year 1 and year 2 visits compared to preoperative examination. The mean corneal thickness at the thinnest point was significantly higher at year 1 and year 2 visits than at preoperative examination (p1 = 0.014 and p2 = 0.017, respectively). No intra- or postoperative complications or adverse reactions were observed. CONCLUSIONS: Transepithelial high-intensity (irradiance of 45 mW/cm2 for 2 minutes and 40 seconds) CXL using 0.25% riboflavin solution was a safe and effective method to halt the progression of keratoconus for a 2-year follow-up period.
Authors: Ana Maria Cunha; Tiago Sardinha; Luís Torrão; Raúl Moreira; Fernando Falcão-Reis; João Pinheiro-Costa Journal: Clin Ophthalmol Date: 2020-08-14
Authors: Carolina Madeira; Ana Vasques; João Beato; Gonçalo Godinho; Luís Torrão; Manuel Falcão; Fernando Falcão-Reis; João Pinheiro-Costa Journal: Clin Ophthalmol Date: 2019-03-01