Repeated Corneal Cross-Linking with Progressive Keratoconus
The purpose is to study the efficacy and safety of repeated UV corneal crosslinking in patients with advanced keratoconus after transepithelial crosslinking performed previously. Patients and methods. A retrospective analysis of the treatment results of 52 patients (52 eyes) with progressive keratoc...
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| Format: | Article |
| Language: | Russian |
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Ophthalmology Publishing Group
2019-04-01
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| Series: | Oftalʹmologiâ |
| Subjects: | |
| Online Access: | https://www.ophthalmojournal.com/opht/article/view/898 |
| _version_ | 1797875430159548416 |
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| author | E. L. Usubov |
| author_facet | E. L. Usubov |
| author_sort | E. L. Usubov |
| collection | DOAJ |
| description | The purpose is to study the efficacy and safety of repeated UV corneal crosslinking in patients with advanced keratoconus after transepithelial crosslinking performed previously. Patients and methods. A retrospective analysis of the treatment results of 52 patients (52 eyes) with progressive keratoconus stage I-II according to the Amsler — Krumeich classification, which from 2012 to 2014 were treated by transepithelial corneal crosslinking. Based on objective clinical studies, the effectiveness of the treatment and the course of the process were evaluated. In some patients with a progressive course of the process (12 eyes), after the transepithelial crosslinking, a procedure of repeated UV crosslinking of the cornea was performed according to a standard protocol. Results. After transepithelial cross-linking within 24 months in 12 eyes (44 %) progression of the disease was observed, manifested by an increase in the refractive power of the cornea by 0.95 ± 0.18 D, a decrease in the thickness of the cornea from 484 ± 156 to 446 ± 87 microns. Repeated cross-linking was performed and after 6 months and positive dynamics was observed in 10 cases (83.3 %), visual acuity reached the preoperative level, the refractive power of the cornea was 50.3 ± 0.84 D. Stabilization of the process was noted in all 12 eyes, a decrease in the average refractive index of the cornea by an average of 1.1 ± 1.25 D, corneal astigmatism — by 1.2 ± 0.31 D, the cornea thickness to 427 ± 38.7 mc.Conclusion. The use of modified crosslinking protocols, in particular transepithelial with iontophoresis, has a lower efficiency, showing stabilization in 56 % of cases, compared to the standard, which must be considered when choosing a clinical approach and selecting patients. Performing recrosslinking using a standard protocol showed high efficiency and safety of the procedure in 100 % of cases, however, this approach should be studied on a larger number of observations. |
| first_indexed | 2024-04-10T01:47:31Z |
| format | Article |
| id | doaj.art-291f9bae455d4af6a99578de707fb863 |
| institution | Directory Open Access Journal |
| issn | 1816-5095 2500-0845 |
| language | Russian |
| last_indexed | 2024-04-10T01:47:31Z |
| publishDate | 2019-04-01 |
| publisher | Ophthalmology Publishing Group |
| record_format | Article |
| series | Oftalʹmologiâ |
| spelling | doaj.art-291f9bae455d4af6a99578de707fb8632023-03-13T09:08:39ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452019-04-01161S566010.18008/1816-5095-2019-1S-56-60514Repeated Corneal Cross-Linking with Progressive KeratoconusE. L. Usubov0ГБУ «Уфимский научно-исследовательский институт глазных болезней Академии наук Республики Башкортостан»The purpose is to study the efficacy and safety of repeated UV corneal crosslinking in patients with advanced keratoconus after transepithelial crosslinking performed previously. Patients and methods. A retrospective analysis of the treatment results of 52 patients (52 eyes) with progressive keratoconus stage I-II according to the Amsler — Krumeich classification, which from 2012 to 2014 were treated by transepithelial corneal crosslinking. Based on objective clinical studies, the effectiveness of the treatment and the course of the process were evaluated. In some patients with a progressive course of the process (12 eyes), after the transepithelial crosslinking, a procedure of repeated UV crosslinking of the cornea was performed according to a standard protocol. Results. After transepithelial cross-linking within 24 months in 12 eyes (44 %) progression of the disease was observed, manifested by an increase in the refractive power of the cornea by 0.95 ± 0.18 D, a decrease in the thickness of the cornea from 484 ± 156 to 446 ± 87 microns. Repeated cross-linking was performed and after 6 months and positive dynamics was observed in 10 cases (83.3 %), visual acuity reached the preoperative level, the refractive power of the cornea was 50.3 ± 0.84 D. Stabilization of the process was noted in all 12 eyes, a decrease in the average refractive index of the cornea by an average of 1.1 ± 1.25 D, corneal astigmatism — by 1.2 ± 0.31 D, the cornea thickness to 427 ± 38.7 mc.Conclusion. The use of modified crosslinking protocols, in particular transepithelial with iontophoresis, has a lower efficiency, showing stabilization in 56 % of cases, compared to the standard, which must be considered when choosing a clinical approach and selecting patients. Performing recrosslinking using a standard protocol showed high efficiency and safety of the procedure in 100 % of cases, however, this approach should be studied on a larger number of observations.https://www.ophthalmojournal.com/opht/article/view/898роговицакератоконускросслинкингкератэктазииуф-облучение |
| spellingShingle | E. L. Usubov Repeated Corneal Cross-Linking with Progressive Keratoconus Oftalʹmologiâ роговица кератоконус кросслинкинг кератэктазии уф-облучение |
| title | Repeated Corneal Cross-Linking with Progressive Keratoconus |
| title_full | Repeated Corneal Cross-Linking with Progressive Keratoconus |
| title_fullStr | Repeated Corneal Cross-Linking with Progressive Keratoconus |
| title_full_unstemmed | Repeated Corneal Cross-Linking with Progressive Keratoconus |
| title_short | Repeated Corneal Cross-Linking with Progressive Keratoconus |
| title_sort | repeated corneal cross linking with progressive keratoconus |
| topic | роговица кератоконус кросслинкинг кератэктазии уф-облучение |
| url | https://www.ophthalmojournal.com/opht/article/view/898 |
| work_keys_str_mv | AT elusubov repeatedcornealcrosslinkingwithprogressivekeratoconus |