Customized Corneal Cross-linking: One-Year Results.
Am J Ophthalmol
; 166: 14-21, 2016 Jun.
Article
em En
| MEDLINE
| ID: mdl-26944278
ABSTRACT
PURPOSE:
To compare the efficacy of customized corneal cross-linking (CXL) with standard CXL.DESIGN:
Prospective, nonrandomized comparative clinical study.METHODS:
In a prospective study at the Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland, 40 eyes of 40 patients with documented progressive primary keratoconus were treated with customized CXL (n = 20) or standard CXL (n = 20) and followed for 1 year. Customized irradiation patterns had an energy fluence of 9 mW/cm(2) and total energy levels ranging from 5.4 J/cm(2) up to 10 J/cm(2) and were centered on the maximum of the posterior float. The control group received homogenous irradiation with a fluence of 9 mW/cm(2) and a total energy of 5.4 J/cm(2). Scheimpflug tomographies, endothelium cell count, best spectacle-corrected visual acuity (BSCVA), and anterior segment optical coherence tomography (OCT) were compared preoperatively and 1 year postoperatively.RESULTS:
Pachymetry and ΔKmax showed significant changes 1 year postoperatively within each group. Epithelial healing time, ΔKmax, and regularization index (RI) were significantly better in the customized CXL group. Two out of 19 eyes (11%) in the standard group but 7 out of 19 eyes (37%) in the customized CXL group showed a flattening of 2 or more diopters (P = .03). The RI was 5.2 ± 2.7 D in the customized group vs 4.1 ± 3.1 D in the control group (P = .03). Statistically significant correlations between RI and preoperative Kmax, preoperative pachymetry, and preoperative posterior float were found only in the customized group.CONCLUSIONS:
Customized CXL seems to be as safe as standard CXL with stronger flattening in Kmax and RI, and a faster epithelial healing period.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fotoquimioterapia
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Riboflavina
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Colágeno
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Fármacos Fotossensibilizantes
/
Substância Própria
/
Reagentes de Ligações Cruzadas
/
Ceratocone
Tipo de estudo:
Observational_studies
Limite:
Adult
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Female
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Humans
/
Male
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article