Naoko Kato1,2,3, Kenji Konomi4, Megumi Shinzawa4, Kozue Kasai4, Takeshi Ide5, Ikuko Toda6, Chikako Sakai7, Kazuno Negishi7, Kazuo Tsubota7, Jun Shimazaki4. 1. Department of Ophthalmology, Saitama Medical University, Morohongo 38, Moroyamamachi, Iruma, Saitama, 350-0495, Japan. naokato@bc.iij4u.or.jp. 2. Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan. naokato@bc.iij4u.or.jp. 3. Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan. naokato@bc.iij4u.or.jp. 4. Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan. 5. Tokyo Vision Eye Clinic Asagaya, Tokyo, Japan. 6. Minamiaoyama Eye Clinic, Tokyo, Japan. 7. Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan.
Abstract
PURPOSE: We retrospectively investigated the efficacy of corneal crosslinking (CXL) on progressive keratoconus in a Japanese population and compared the outcomes of conventional and accelerated CXL. STUDY DESIGN: A retrospective cohort study METHODS: A total of 108 consecutive eyes in 95 patients (75 men; 21.9 ± 6.2 years) with progressive keratoconus were enrolled. The epithelium was ablated in all eyes. After presoaking the corneal stroma in riboflavin, UV-A was irradiated at 3.0 mW/cm2 (conventional CXL) for 30 min on 23 eyes and 18.0 mW/cm2 for 5 min (accelerated CXL) on 85 eyes. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometric value, corneal thickness, corneal endothelial cell density (ECD), intraocular pressure, and complications were evaluated at 1, 3, 6, and 12 months after the procedure. RESULTS: BSCVA, manifest refraction, ECD, and corneal thickness did not change significantly after both procedures. The keratometric value was significantly decreased from the preoperative value at 12 months (p < 0.001). Progression to more than 1.0 D after CXL was observed in 10 eyes (9.3%). The ΔKmax was negatively associated with preoperative Kmax (p < 0.001) and positively associated with preoperative thinnest corneal thickness (p < 0.001). Both treatment modules showed no significant difference in all parameters. CONCLUSION: CXL was as effective in treating keratoconus in Japanese patients as in individuals of other ethnicities. Overall, CXL could be performed using either the conventional or accelerated approach to halt the progression of keratoconus in Japanese populations.
PURPOSE: We retrospectively investigated the efficacy of corneal crosslinking (CXL) on progressive keratoconus in a Japanese population and compared the outcomes of conventional and accelerated CXL. STUDY DESIGN: A retrospective cohort study METHODS: A total of 108 consecutive eyes in 95 patients (75 men; 21.9 ± 6.2 years) with progressive keratoconus were enrolled. The epithelium was ablated in all eyes. After presoaking the corneal stroma in riboflavin, UV-A was irradiated at 3.0 mW/cm2 (conventional CXL) for 30 min on 23 eyes and 18.0 mW/cm2 for 5 min (accelerated CXL) on 85 eyes. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometric value, corneal thickness, corneal endothelial cell density (ECD), intraocular pressure, and complications were evaluated at 1, 3, 6, and 12 months after the procedure. RESULTS: BSCVA, manifest refraction, ECD, and corneal thickness did not change significantly after both procedures. The keratometric value was significantly decreased from the preoperative value at 12 months (p < 0.001). Progression to more than 1.0 D after CXL was observed in 10 eyes (9.3%). The ΔKmax was negatively associated with preoperative Kmax (p < 0.001) and positively associated with preoperative thinnest corneal thickness (p < 0.001). Both treatment modules showed no significant difference in all parameters. CONCLUSION:CXL was as effective in treating keratoconus in Japanese patients as in individuals of other ethnicities. Overall, CXL could be performed using either the conventional or accelerated approach to halt the progression of keratoconus in Japanese populations.
Entities:
Keywords:
Accelerated crosslinking; Corneal crosslinking; Corneal flattening; East Asian; Keratoconus
Authors: Mohammad A Seyedian; Soheil Aliakbari; Mohammad Miraftab; Hassan Hashemi; Soheila Asgari; Mehdi Khabazkhoob Journal: Middle East Afr J Ophthalmol Date: 2015 Jul-Sep