ABSTRACT
PURPOSE: We aimed to compare the efficacy and safety of accelerated contact lens-assisted cross-linking (CA-CXL) with Lotrafilcon B and Comfilcon A lenses in keratoconus (KC) patients with thin corneas. STUDY DESIGN: Retrospective, single-center study. MATERIALS AND METHODS: We retrospectively included 51 eyes of 39 KC patients with corneal thickness <400µm after epithelial scraping (Epi-off), who underwent accelerated CA-CXL treatment with Lotrafilcon B (n=20) and Comfilcon A (n=31). Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest refraction values, corneal topographic data and endothelial cell density were recorded at preoperative and postoperative 1st, 3rd and 6th month controls. RESULTS: CDVA in the Comfilcon A group was higher than CDVA before surgery at 6 months postoperatively (p<0.001). When the two lenses were compared, CDVA was found to be significantly higher in the Lotrafilcon B group in the preoperative, postoperative 1st month and 3rd month values, but there was no significant difference between the postoperative 6th month values (p=0.028, p=0.018, p=0.044, p=0.181, respectively). The maximum keratometry (Kmax) value at the 6th month after surgery in the Comfilcon A group was significantly lower than in the Lotrafilcon B group (p=0,009). There was no significant difference between the endothelial cell density values between the groups (p=0.623, p=0.609, p=0.794, p=0.458, respectively). There was no significant difference between the progression, regression, and stability rates of the two groups (p=0.714). CONCLUSIONS: Accelerated CA-CXL with Lotrafilcon B and Comfilcon A silicone hydrogel lenses is a safe and effective method to stop progression in patients with thin corneas.
Subject(s)
Collagen , Corneal Topography , Cross-Linking Reagents , Keratoconus , Photochemotherapy , Photosensitizing Agents , Refraction, Ocular , Riboflavin , Visual Acuity , Humans , Keratoconus/diagnosis , Keratoconus/physiopathology , Keratoconus/drug therapy , Keratoconus/therapy , Keratoconus/metabolism , Female , Male , Retrospective Studies , Visual Acuity/physiology , Photosensitizing Agents/therapeutic use , Adult , Riboflavin/therapeutic use , Photochemotherapy/methods , Young Adult , Refraction, Ocular/physiology , Collagen/metabolism , Treatment Outcome , Cornea/pathology , Ultraviolet Rays , Follow-Up Studies , Adolescent , Cell Count , Corneal Stroma/metabolism , Endothelium, Corneal/pathology , Contact Lenses, Hydrophilic , Corneal Cross-LinkingABSTRACT
OBJECTIVES: This is a retrospective, comparative evaluation of the short-term efficacy and safety of intravitreal ranibizumab (IVR) and IVR combined with posterior subtenon triamcinolone acetonide (STA) in the treatment of diabetic macular oedema (DME). METHODS: A total of 79 pseudophakic eyes of 57 patients with DME who underwent IVR injection treatment were examined retrospectively. All of the patients were treatment-naive. In the study group (STA+IVR), consisting of 30 eyes of 39 patients, the STA and IVR were administered in the first treatment session simultaneously, followed by 2 consecutive monthly IVR injections. In the control group (IVR only) comprised 40 eyes of 27 patients, 3 consecutive monthly IVR injections were administered. Patients with serous retinal detachment (SRD) according to optical coherence tomography images were identified in both groups for subgroup analyses. The primary outcome measures were changes in central macular thickness (CMT), best corrected visual acuity (BCVA), and the intraocular pressure (IOP) at 1, 2, and 3 months post-injection. RESULTS: There was no statistically significant difference between the demographic characteristics of the patients' baseline BCVA and CMT measurements (p>0.05). For the IVR group, the mean pre-treatment CMT and BCVA was 421.20±89.10 µm and 0.42±0.24 logMAR, respectively. After the third injection, the mean was 308.12±59.07 µm and 0.20±0.12 logMAR, respectively. The combined treatment group baseline measurements were 454.50±122.52 µm and 0.54±0.29 logMAR, respectively. After the third injection, the mean was 294.22±50.33 µm and 0.27±0.21 logMAR, respectively. The decrease was statistically significant for both groups (p=0.001). Comparison of the CMT within groups revealed a statistically significant difference in favor of the combined group after the second injection (p=0.017). There was no statistically significant difference in the BCVA gains between groups (p>0.05). Patients with SRD were evaluated as a subgroup, and at the first month, the mean gain in CMT was -71.63±57.98 µm in the control group and -123.61±93.46 µm in the study group (p=0.048). The required anti-glaucomatous treatment was statistically significant in the combined group (p=0.008). CONCLUSION: Both treatments provided improvement in BCVA and CMT and can be considered functional and anatomically effective treatment options for DME.
