Efstathios Vounotrypidis1, Alexis Athanasiou2, Karsten Kortüm2, Daniel Kook2, Mehdi Shajari3, Siegfried Priglinger2, Wolfgang J Mayer2. 1. Department of Ophthalmology, University Hospital, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, D-80336, Munich, Germany. evounotr@med.lmu.de. 2. Department of Ophthalmology, University Hospital, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, D-80336, Munich, Germany. 3. Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany.
Abstract
PURPOSE: To investigate the long-term efficacy of accelerated corneal collagen cross-linking (CXL) in a large mid-European cohort with progressive keratoconus. METHODS: Four hundred thirteen eyes of 316 patients with progressive keratoconus were enrolled and treated with conventional (group A) or accelerated (group B) CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), slit lamp, and Pentacam® examinations were performed before and 12, 24, and 36 months after surgery. Maximum and mean anterior keratometry (Kmax, Kmf), corneal topography indices, and corneal pachymetry (TCT) were examined within each group and between groups. Further subgroup analysis of mild and moderate keratoconic eyes was performed. RESULTS: One hundred thirty-one eyes of 101 patients were treated in group A, 282 eyes of 215 patients in group B. (UDVA, CDVA) and Kmax improved within each group, but not statistically significantly between groups after 36 months (p = 0.081, p = 0.344, p = 0.113, respectively). Kmf remained stable in both groups. TCT decreased significantly in group A (p = 0.014), but remained stable in group B (p = 0.063). Subgroup analysis showed similar results with improvement in visual acuity and keratometry and decrease of TCT. Corneal topography indices showed no differences between the groups after 36 months, but developed differently in the subgroup analysis. No correlation was detected between the change of corneal topography indices and TCT with regard to preoperative Kmax. CONCLUSION: In a large mid-European study population including subgroup analysis of mild and moderate keratoconus, accelerated CXL showed similar results to conventional CXL regarding keratometry, corneal topography indices, and CDVA, but further improvement of UDVA. Preoperative Kmax did not affect the postoperative course of corneal topography indices and TCT.
PURPOSE: To investigate the long-term efficacy of accelerated corneal collagen cross-linking (CXL) in a large mid-European cohort with progressive keratoconus. METHODS: Four hundred thirteen eyes of 316 patients with progressive keratoconus were enrolled and treated with conventional (group A) or accelerated (group B) CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), slit lamp, and Pentacam® examinations were performed before and 12, 24, and 36 months after surgery. Maximum and mean anterior keratometry (Kmax, Kmf), corneal topography indices, and corneal pachymetry (TCT) were examined within each group and between groups. Further subgroup analysis of mild and moderate keratoconic eyes was performed. RESULTS: One hundred thirty-one eyes of 101 patients were treated in group A, 282 eyes of 215 patients in group B. (UDVA, CDVA) and Kmax improved within each group, but not statistically significantly between groups after 36 months (p = 0.081, p = 0.344, p = 0.113, respectively). Kmf remained stable in both groups. TCT decreased significantly in group A (p = 0.014), but remained stable in group B (p = 0.063). Subgroup analysis showed similar results with improvement in visual acuity and keratometry and decrease of TCT. Corneal topography indices showed no differences between the groups after 36 months, but developed differently in the subgroup analysis. No correlation was detected between the change of corneal topography indices and TCT with regard to preoperative Kmax. CONCLUSION: In a large mid-European study population including subgroup analysis of mild and moderate keratoconus, accelerated CXL showed similar results to conventional CXL regarding keratometry, corneal topography indices, and CDVA, but further improvement of UDVA. Preoperative Kmax did not affect the postoperative course of corneal topography indices and TCT.
Authors: Natalia T Giacomin; Marcelo V Netto; André A M Torricelli; Gustavo K Marino; Samir J Bechara; Rodrigo F Espíndola; Marcony R Santhiago Journal: J Refract Surg Date: 2016-07-01 Impact factor: 3.573
Authors: George D Kymionis; Michael A Grentzelos; Vardhaman P Kankariya; Dimitrios A Liakopoulos; Dimitra M Portaliou; Konstantinos I Tsoulnaras; Alexandra E Karavitaki; Aristophanis I Pallikaris Journal: J Cataract Refract Surg Date: 2014-08 Impact factor: 3.351
Authors: Emilio Pedrotti; Grazia Caldarella; Adriano Fasolo; Erika Bonacci; Nicola Gennaro; Alessandra De Gregorio; Giorgio Marchini Journal: Int J Environ Res Public Health Date: 2019-10-12 Impact factor: 3.390