Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus
Abstract Background The purpose of this study was to identify differences in clinical corneal findings after standard and accelerated epithelial off cross-linking (CXL) during a long-term follow-up. Methods Two hundred forty-one patients (184 male) were included in this monocentric, retrospective, n...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-11-01
|
| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12886-017-0610-4 |
| _version_ | 1828766130836078592 |
|---|---|
| author | Karsten U. Kortuem Efstathios Vounotrypidis Alexandros Athanasiou Michael Müller Alexander Babenko Christoph Kern Siegfried Priglinger Wolfgang J. Mayer |
| author_facet | Karsten U. Kortuem Efstathios Vounotrypidis Alexandros Athanasiou Michael Müller Alexander Babenko Christoph Kern Siegfried Priglinger Wolfgang J. Mayer |
| author_sort | Karsten U. Kortuem |
| collection | DOAJ |
| description | Abstract Background The purpose of this study was to identify differences in clinical corneal findings after standard and accelerated epithelial off cross-linking (CXL) during a long-term follow-up. Methods Two hundred forty-one patients (184 male) were included in this monocentric, retrospective, non-randomized and unmasked study. One hundred forty-eight eyes were treated with the accelerated protocol and 138 with the standard protocol with epithelial off CXL, if diagnosed with keratoconus and a progression in Kmax of more than one dioptre during the preceding 6 months, plus a minimal pachymetry measurement of 400 μm in keratometry (Pentacam, Oculus GmbH, Wetzlar, Germany). Exclusion criteria were previous surgery, other corneal conditions or age above 50 years. Follow-up time was 36 months with clinical examination and keratometry at every visit. Outcome measures were the observed rate of corneal changes, differences between treatment groups and correlation with keratometry measurements. Results In patients with accelerated CXL, significantly more clear corneas were seen at three (p = 0.015) and six (p = 0.002) months after surgery than following the standard protocol. The rate of clear corneas dropped from 52.2% pre-operation (OP) to a minimum of 19.3% after 6 months in the standard protocol group compared with 50.7% clear corneas pre-OP and a minimum of 40.8% in the accelerated group. In the standard protocol group, more striae were found 3 months after intervention than in the accelerated group (p = 0.05). Conclusions In patients with accelerated CXL, fewer morphological corneal changes were observed than after conventional CXL. However, rarely, corneal changes persisted for a long time. |
| first_indexed | 2024-12-11T06:59:43Z |
| format | Article |
| id | doaj.art-04d489bd9fc2480c87fef8435023ec99 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-11T06:59:43Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-04d489bd9fc2480c87fef8435023ec992022-12-22T01:16:39ZengBMCBMC Ophthalmology1471-24152017-11-011711810.1186/s12886-017-0610-4Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconusKarsten U. Kortuem0Efstathios Vounotrypidis1Alexandros Athanasiou2Michael Müller3Alexander Babenko4Christoph Kern5Siegfried Priglinger6Wolfgang J. Mayer7Department of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichDepartment of Ophthalmology, Ludwig-Maximilians-University MunichAbstract Background The purpose of this study was to identify differences in clinical corneal findings after standard and accelerated epithelial off cross-linking (CXL) during a long-term follow-up. Methods Two hundred forty-one patients (184 male) were included in this monocentric, retrospective, non-randomized and unmasked study. One hundred forty-eight eyes were treated with the accelerated protocol and 138 with the standard protocol with epithelial off CXL, if diagnosed with keratoconus and a progression in Kmax of more than one dioptre during the preceding 6 months, plus a minimal pachymetry measurement of 400 μm in keratometry (Pentacam, Oculus GmbH, Wetzlar, Germany). Exclusion criteria were previous surgery, other corneal conditions or age above 50 years. Follow-up time was 36 months with clinical examination and keratometry at every visit. Outcome measures were the observed rate of corneal changes, differences between treatment groups and correlation with keratometry measurements. Results In patients with accelerated CXL, significantly more clear corneas were seen at three (p = 0.015) and six (p = 0.002) months after surgery than following the standard protocol. The rate of clear corneas dropped from 52.2% pre-operation (OP) to a minimum of 19.3% after 6 months in the standard protocol group compared with 50.7% clear corneas pre-OP and a minimum of 40.8% in the accelerated group. In the standard protocol group, more striae were found 3 months after intervention than in the accelerated group (p = 0.05). Conclusions In patients with accelerated CXL, fewer morphological corneal changes were observed than after conventional CXL. However, rarely, corneal changes persisted for a long time.http://link.springer.com/article/10.1186/s12886-017-0610-4KeratoconusCross-linkingAccelerated cross-linkingCorneal findings |
| spellingShingle | Karsten U. Kortuem Efstathios Vounotrypidis Alexandros Athanasiou Michael Müller Alexander Babenko Christoph Kern Siegfried Priglinger Wolfgang J. Mayer Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus BMC Ophthalmology Keratoconus Cross-linking Accelerated cross-linking Corneal findings |
| title | Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus |
| title_full | Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus |
| title_fullStr | Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus |
| title_full_unstemmed | Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus |
| title_short | Differences in corneal clinical findings after standard and accelerated cross-linking in patients with progressive keratoconus |
| title_sort | differences in corneal clinical findings after standard and accelerated cross linking in patients with progressive keratoconus |
| topic | Keratoconus Cross-linking Accelerated cross-linking Corneal findings |
| url | http://link.springer.com/article/10.1186/s12886-017-0610-4 |
| work_keys_str_mv | AT karstenukortuem differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT efstathiosvounotrypidis differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT alexandrosathanasiou differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT michaelmuller differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT alexanderbabenko differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT christophkern differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT siegfriedpriglinger differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus AT wolfgangjmayer differencesincornealclinicalfindingsafterstandardandacceleratedcrosslinkinginpatientswithprogressivekeratoconus |