Mazen M Sinjab1,2, Roy S Rubinfeld3,4, Kirsten Wagner5,6, Edward C Parsons Jnr7, Arthur B Cummings8, Michael W Belin9. 1. Dr. Mazen Eye Clinic, Medcare Hospitals and Centres, Dubai, United Arab Emirates. 2. Al Zahra Medical Group, Damascus, Syria. 3. Department of Ophthalmology, Georgetown University Medical School/Washington Hospital Center, Washington, DC, USA. 4. Re:Vision Private Practice, Rockville, MD, USA. 5. Department of Ophthalmology, Medstar Georgetown University Hospital, Washington, DC, USA. 6. Department of Ophthalmology, Medstar Washington Hospital Center, Washington, DC, USA. 7. CXL Ophthalmics, Encinitas, CA, USA. 8. Wellington Eye Clinic, Dublin, Ireland. 9. Department of Ophthalmology, University of Arizona, Tucson, AZ, USA.
Abstract
PURPOSE: To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK. METHODS: Retrospective, exploratory cohort study. Patients with keratoconus or postsurgical ectasia and best spectacle-corrected distance VA (CDVA) ≤ 20/40 were included. Conductive keratoplasty was performed (ViewPoint CK System, Refractec, Inc., Bloomington, MN); followed a day later by epi-on CXL (CXLUSA/CXLO, Bethesda, MD/CXLO Encinitas, CA). Measures included uncorrected distance visual acuity (UDVA) and CDVA, as well as refractive and tomographic measures and tomographic indices. RESULTS: Data from 50 eyes of 45 patients were analyzed. Mean follow-up was 15.1 ± 12.2 months (range: 2 to 51). Overall, UDVA and CDVA improved postoperatively. Subjective refraction and tomographic metrics did not show consistent changes, but changes in tomographic indices were associated with treatment follow-up time. At the 1-year visit, mean UDVA significantly improved over baseline (P = 0.009) by approximately 3 lines; mean CDVA improved significantly (P = 10-5) by approximately 2 lines. No eye lost lines of CDVA. Change in the Index of Surface Variance (ISV) was associated with treatment, and the D-Index trended over follow-up time. CONCLUSION: Conductive keratoplasty with a proprietary epi-on CXL treatment improved vision in patients with advanced ectasia This CK/epi-on CXL treatment offers the possibility of improved VA for patients with compromised vision due to ectasia.
PURPOSE: To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK. METHODS: Retrospective, exploratory cohort study. Patients with keratoconus or postsurgical ectasia and best spectacle-corrected distance VA (CDVA) ≤ 20/40 were included. Conductive keratoplasty was performed (ViewPoint CK System, Refractec, Inc., Bloomington, MN); followed a day later by epi-on CXL (CXLUSA/CXLO, Bethesda, MD/CXLO Encinitas, CA). Measures included uncorrected distance visual acuity (UDVA) and CDVA, as well as refractive and tomographic measures and tomographic indices. RESULTS: Data from 50 eyes of 45 patients were analyzed. Mean follow-up was 15.1 ± 12.2 months (range: 2 to 51). Overall, UDVA and CDVA improved postoperatively. Subjective refraction and tomographic metrics did not show consistent changes, but changes in tomographic indices were associated with treatment follow-up time. At the 1-year visit, mean UDVA significantly improved over baseline (P = 0.009) by approximately 3 lines; mean CDVA improved significantly (P = 10-5) by approximately 2 lines. No eye lost lines of CDVA. Change in the Index of Surface Variance (ISV) was associated with treatment, and the D-Index trended over follow-up time. CONCLUSION: Conductive keratoplasty with a proprietary epi-on CXL treatment improved vision in patients with advanced ectasia This CK/epi-on CXL treatment offers the possibility of improved VA for patients with compromised vision due to ectasia.
Authors: Daniel A Godefrooij; Marie-Josee J Mangen; Elsie Chan; David P S O'Brart; Saskia M Imhof; G Ardine de Wit; Robert P L Wisse Journal: Ophthalmology Date: 2017-05-19 Impact factor: 12.079
Authors: Mustafa Kapasi; Jasrabir Baath; George Mintsioulis; W Bruce Jackson; Kashif Baig Journal: Can J Ophthalmol Date: 2012-06-05 Impact factor: 1.882