LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS
Purpose. To compare a clinical effectiveness of different UV-crosslinking techniques in patients with progressive keratoconus.Material and methods. Randomized prospective clinical trial included 130 eyes of 117 keratoconic patients. There were created 2 equal groups of 65 eyes. In the group I patien...
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| Format: | Article |
| Language: | Russian |
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Publishing house "Ophthalmology"
2015-10-01
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| Series: | Офтальмохирургия |
| Subjects: | |
| Online Access: | https://www.ophthalmosurgery.ru/jour/article/view/54 |
| _version_ | 1828057734125191168 |
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| author | B. E. Malyugin S. B. Izmailova D. E. Merzlov S. A. Pronkina E. P. Poruchikova A. Y. Semykin |
| author_facet | B. E. Malyugin S. B. Izmailova D. E. Merzlov S. A. Pronkina E. P. Poruchikova A. Y. Semykin |
| author_sort | B. E. Malyugin |
| collection | DOAJ |
| description | Purpose. To compare a clinical effectiveness of different UV-crosslinking techniques in patients with progressive keratoconus.Material and methods. Randomized prospective clinical trial included 130 eyes of 117 keratoconic patients. There were created 2 equal groups of 65 eyes. In the group I patients underwent a classical UV-crosslinking technique with a complete central corneal deepithelialization, in the group II a UV-crosslinking with dosed corneal epithelium scarification was performed using a new device. The postoperative follow-up period was 24 months. Preoperatively in the group I the uncorrected visual acuity (UCVA) was 0.21±0.11, the best corrected visual acuity (BCVA) was 0.49±0.14, the central corneal pachymetry (CCP) – 469.1±23/4μm, the mean keratometry (Kave) – 46.1±1.7D, in the group II: UCVA was 0.22±0.09, BCVA – 0.48±0.12, CCP – 475.2±28.5μm, Кave – 46.7±1.4D.Results. The mean postoperative pain score was 6.9±1.3, relief on the 3-rd ±1.2 day post-op. in the group I, and 2.8±1.1 relief on the 1-st±0.4 day post-op. in the group II. All patients had a 0.1 to 0.12 visual acuity loss 7 days after the surgery that was due to a mild corneal opacification. At 3 months after operation in both groups the UCVA and the BCVA were back to their preoperative values. In the group I the UCVA increased by 0.07±0.03 (р<0.05) 2 years after the treatment, the BCVA increased by 0.11±0.04 (р<0.05). At that time in the group II the similar values were obtained: 0.08±0.02 (р<0.05), 0.1±0.04 (р<0.05) respectively. The Kave index in both groups gradually decreased during first 12 months after operation and then stabilized. At the end of the follow up it was lower by 2.6±0.5D (р<0.05) in the group I and by 2.4±0.3D (р<0.05) in the group II. According to the anterior OCT, the depth of demarcation line was 327±11μm in the group I and 318±13μm in the group II. The demarcation line was absent in all cases 12 months after surgery. In the early postoperative period 3 months after operation the CCP gradually decreased. It reduced by 3.77±0.83% (р<0.05) in the group I and by 3.17±0.88% (р<0.05) in the group II. After that the CCP slowly increased during the entire follow-up, but 24 months later it was still lower by 2.36±0.57% (р<0.05) in the group I and by 1.68%±0.75 (р<0.05) in the group II. Confocal microscopy 1 month after surgery revealed typical changes of corneal structure at the depth up to 310±9μm (290 to 335) in the group I and 300±8μm (280 to 330) in the group II. A full reinnervation and the repopulation of the cornea with keratocytes was seen 6 months after operation. The only complication (delayed corneal epithelization) was in the group with classical UV-crosslinking technique.Conclusions. The trial revealed similar clinical outcomes after classical UV-crosslinking technique and UV-crosslinking with dosed corneal epithelium scarification, however in the latter case during the postoperative period the severity and duration of pain were significantly reduced. |
| first_indexed | 2024-04-10T21:16:55Z |
| format | Article |
| id | doaj.art-ec53bb792d5d4f53b33c8d28becc32df |
| institution | Directory Open Access Journal |
| issn | 0235-4160 2312-4970 |
| language | Russian |
| last_indexed | 2024-04-10T21:16:55Z |
| publishDate | 2015-10-01 |
| publisher | Publishing house "Ophthalmology" |
| record_format | Article |
| series | Офтальмохирургия |
| spelling | doaj.art-ec53bb792d5d4f53b33c8d28becc32df2023-01-20T12:34:48ZrusPublishing house "Ophthalmology"Офтальмохирургия0235-41602312-49702015-10-0104424954LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUSB. E. Malyugin0S. B. Izmailova1D. E. Merzlov2S. A. Pronkina3E. P. Poruchikova4A. Y. Semykin5The S. Fyodorov Eye Microsurgery Federal State Institution, MoscowThe S. Fyodorov Eye Microsurgery Federal State Institution, MoscowThe S. Fyodorov Eye Microsurgery Federal State Institution, MoscowThe S. Fyodorov Eye Microsurgery Federal State Institution, MoscowThe S. Fyodorov Eye Microsurgery Federal State Institution, MoscowThe S. Fyodorov Eye Microsurgery Federal State Institution, MoscowPurpose. To compare a clinical effectiveness of different UV-crosslinking techniques in patients with progressive keratoconus.Material and methods. Randomized prospective clinical trial included 130 eyes of 117 keratoconic patients. There were created 2 equal groups of 65 eyes. In the group I patients underwent a classical UV-crosslinking technique with a complete central corneal deepithelialization, in the group II a UV-crosslinking with dosed corneal epithelium scarification was performed using a new device. The postoperative follow-up period was 24 months. Preoperatively in the group I the uncorrected visual acuity (UCVA) was 0.21±0.11, the best corrected visual acuity (BCVA) was 0.49±0.14, the central corneal pachymetry (CCP) – 469.1±23/4μm, the mean keratometry (Kave) – 46.1±1.7D, in the group II: UCVA was 0.22±0.09, BCVA – 0.48±0.12, CCP – 475.2±28.5μm, Кave – 46.7±1.4D.Results. The mean postoperative pain score was 6.9±1.3, relief on the 3-rd ±1.2 day post-op. in the group I, and 2.8±1.1 relief on the 1-st±0.4 day post-op. in the group II. All patients had a 0.1 to 0.12 visual acuity loss 7 days after the surgery that was due to a mild corneal opacification. At 3 months after operation in both groups the UCVA and the BCVA were back to their preoperative values. In the group I the UCVA increased by 0.07±0.03 (р<0.05) 2 years after the treatment, the BCVA increased by 0.11±0.04 (р<0.05). At that time in the group II the similar values were obtained: 0.08±0.02 (р<0.05), 0.1±0.04 (р<0.05) respectively. The Kave index in both groups gradually decreased during first 12 months after operation and then stabilized. At the end of the follow up it was lower by 2.6±0.5D (р<0.05) in the group I and by 2.4±0.3D (р<0.05) in the group II. According to the anterior OCT, the depth of demarcation line was 327±11μm in the group I and 318±13μm in the group II. The demarcation line was absent in all cases 12 months after surgery. In the early postoperative period 3 months after operation the CCP gradually decreased. It reduced by 3.77±0.83% (р<0.05) in the group I and by 3.17±0.88% (р<0.05) in the group II. After that the CCP slowly increased during the entire follow-up, but 24 months later it was still lower by 2.36±0.57% (р<0.05) in the group I and by 1.68%±0.75 (р<0.05) in the group II. Confocal microscopy 1 month after surgery revealed typical changes of corneal structure at the depth up to 310±9μm (290 to 335) in the group I and 300±8μm (280 to 330) in the group II. A full reinnervation and the repopulation of the cornea with keratocytes was seen 6 months after operation. The only complication (delayed corneal epithelization) was in the group with classical UV-crosslinking technique.Conclusions. The trial revealed similar clinical outcomes after classical UV-crosslinking technique and UV-crosslinking with dosed corneal epithelium scarification, however in the latter case during the postoperative period the severity and duration of pain were significantly reduced.https://www.ophthalmosurgery.ru/jour/article/view/54keratoconuscorneauv-crosslinkingepithelium scarificationconfocal microscopy |
| spellingShingle | B. E. Malyugin S. B. Izmailova D. E. Merzlov S. A. Pronkina E. P. Poruchikova A. Y. Semykin LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS Офтальмохирургия keratoconus cornea uv-crosslinking epithelium scarification confocal microscopy |
| title | LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS |
| title_full | LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS |
| title_fullStr | LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS |
| title_full_unstemmed | LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS |
| title_short | LONG-TERM RESULTS OF DIFFERENT UV-CROSSLINKING TECHNIQUES IN PATIENTS WITH PROGRESSIVE KERATOCONUS |
| title_sort | long term results of different uv crosslinking techniques in patients with progressive keratoconus |
| topic | keratoconus cornea uv-crosslinking epithelium scarification confocal microscopy |
| url | https://www.ophthalmosurgery.ru/jour/article/view/54 |
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