International Journal of Keratoconus and Ectatic Corneal Diseases

Register      Login

VOLUME 3 , ISSUE 2 ( May-August, 2014 ) > List of Articles

RESEARCH ARTICLE

Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus

PS David O’Brart, Parul Patel, Naomi A O’Brart

Citation Information : O’Brart PD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014; 3 (2):63-68.

DOI: 10.5005/jp-journals-10025-1081

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims

To determine the long-term efficacy and safety of riboflavin/ultraviolet a corneal cross-linking (CXL) to halt the progression of keratoconus.

Materials and methods

Thirty-five patients (35 eyes) who had undergone CXL with epithelial removal 5 or more years previously were examined.

Results

At 5 years, mean spherical equivalent (SEQ) increased by 0.78 diopters (D) (p < 0.001), mean simulated K (Sim K) reduced by 0.86D (p < 0.00001), cone apex power (CAP) reduced by 1.1D (p < 0.0002) and root mean square (RMS) (p < 0.0001), coma (p < 0.0001), and secondary astigmatism (p < 0.001) decreased compared to preoperative values. Compared to values at 1 year, mean refractive cylinder reduced by 0.26D (p < 0.05), mean Sim K reduced by 0.46D (p < 0.0005), CAP reduced by 0.81D (p < 0.01), RMS (p < 0.001), coma (p < 0.002) and secondary astigmatism (p < 0.02) reduced and central pachymetry increased (p < 0.05) at 5 years. No treated eyes showed evidence of progression at 5 years. None lost >1 line of CDVA. Eight untreated fellow eyes progressed during the follow-up period and underwent CXL.

Conclusions

Corneal cross-linking is an effective treatment to halt the progression of keratoconus at 5 years, with no sight-threatening complications. Improvements in topographic and wave-front indices present at 1 year continue to improve at 5 years.

How to cite this article

O’Brart PSD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014;3(2):63-68.


PDF Share
  1. Cross-linking treatment of progressive keratoconus: new hope. Curr Opin Ophthalmol 2006;17:356-360.
  2. Stress-strain measurements of human and porcine cornea after riboflavin/ultraviolet: a induced cross-linking. J Cataract Refract Surg 2003;29:1780-1785.
  3. Untersuchungen zur Verfestigung der Hornhaut am Kaninchen. Ophthalmologe 2000; 97:203-206.
  4. Increased resistance of cross- linked cornea against enzymatic digestion. Curr Eye Res 2004;29:35-40.
  5. Thermomechanical behaviour of collagen cross-linked porcine cornea. Ophthalmologica 2004;218:136-140.
  6. Riboflavin/ultraviolet-A-induced collagen cross-linking for the treatment of keratoconus. Am J Ophthalmol 2003;135:620-627.
  7. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study. J Cataract Refract Surg 2006;32:837-845.
  8. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmol 2009;116: 369-378.
  9. Contralateral eye study of corneal collagen cross-linking with riboflavin and UVA irradiation in patients with keratoconus. J Refract Surg 2009;25:371-376.
  10. A randomised, prospective, bilateral study to investigate the efficacy of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linkage to halt the progression of keratoconus. Br J Ophthalmol 2011 Nov;. Br J Ophthalmol 2011 Nov; 95(11):1519-1524.
  11. Keratoconus and related non-inflammatory corneal thinning disorders. Surv Ophthalmol 1984;28:293-322.
  12. Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg 2008;34:796-801.
  13. Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study. Am J Ophthalmol 2010 Apr;149(4):585-593.
  14. Long-term follow-up of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linking to halt the progression of keratoconus. Br J Ophthalmol 2013 Apr;97(4):433-437.
  15. The cone location and magnitude index. Cornea 2008;27:480-487.
  16. Vector analysis of astigmatism. J Cat Refract Surg 1993;19:393-398.
  17. Corneal collagen cross-linking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg 2011 Jan;37(1):149-160.
  18. Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 2012 Sep;154(3):520-526.
  19. Corneal collagen cross-linking for ectasia after LASIK and photorefractive keratectomy: long-term results. Ophthalmology 2013 Jul;120(7):1354-1359.
  20. A 48-year clinical and epidemiological study of keratoconus. Am J Ophthalmol 1986 Mar 15;101(3):267-273.
  21. Outcomes of penetrating keratoplasty in keratoconus. Cornea 2005;24:941-946.
  22. Complication and failure rates after corneal cross-linking. J Cataract Refract Surg 2009 Aug; 35(8):1358-1362.
  23. Expression of degradative enzymes and protease inhibitors in corneas with keratoconus. Invest Ophthalmol Vis Sci 1998;39: 1117-1124.
  24. Biomechanical properties of keratoconus and normal corneas. Exp Eye Res 1980 Oct; 31(4):435-441.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.