International Journal of Keratoconus and Ectatic Corneal Diseases

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  11 (2024)
Volume  10 (2023)
Volume  9 (2020)
Volume  8 (2019)
Volume  7 (2018)
Volume  6 (2017)
Volume  5 (2016)
Volume  4 (2015)
Volume  3 (2014)
Volume  2 (2013)
Volume  1 (2012)
Related articles

VOLUME 11 , ISSUE 1 ( January-December, 2024 ) > List of Articles

ORIGINAL RESEARCH

Three-year Results of Customized Corneal Collagen Cross-linking for Keratoconus Patients in Oman

Rashid Al Saidi, Devdatta Deshmukh, Ashoka Bandara, Jithin Babu, Naufal Mundemkattil

Keywords : Corneal collagen cross-linking, Customized, Customized corneal collagen cross-linking, Epi-off, Keratoconus

Citation Information : Al Saidi R, Deshmukh D, Bandara A, Babu J, Mundemkattil N. Three-year Results of Customized Corneal Collagen Cross-linking for Keratoconus Patients in Oman. Int J Kerat Ect Cor Dis 2024; 11 (1):1-6.

DOI: 10.5005/jp-journals-10025-1206

License: CC BY-NC 4.0

Published Online: 21-02-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Purpose: This 3-year study examined the safety and efficacy of customized corneal collagen cross-linking (CuRV) for keratoconus in patients from Oman. Methods: Corneal collagen cross-linking was initiated by the application of 0.1% riboflavin. Targeted ultraviolet-A light was applied to the treatment area, and the energy levels were customized according to the topographic findings. Efficacy assessments were conducted preoperatively and postoperatively at 1, 6, 12, 24, and 36 months. Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), maximum keratometry (Kmax), mean keratometry (Kmean), and corneal pachymetry were measured. Results: Most eyes (17/20 or 85% and 15/20 or 75%) improved or remained stable in UCVA or BCVA, respectively, between baseline and 36 months. Mean changes in Kmax from baseline were significant at 6−36 months, ranging from −1.4 to −2.1 D of flattening. Most (80%) eyes demonstrated ≥1 D of flattening at 36 months compared with baseline. At 36 months, mean pachymetry values showed corneal thinning at 6 and 24 months compared with baseline values (p < 0.05). In terms of safety, 15 and 25% of eyes showed small deteriorations of UCVA and BCVA, respectively. Conclusions: Overall, CuRV was safe and effective for long-term stabilization of keratoconus progression. Stable improvement in visual function and corneal flattening were observed over the 3-year follow-up period.

PDF Share
  1. Santodomingo-Rubido J, Carracedo G, Suzaki A, et al. Keratoconus: An updated review. Cont Lens Anterior Eye 2022;45(3):101559. DOI: 10.1016/j.clae.2021.101559.
  2. Nichols JJ, Steger-May K, Edrington TB, et al. The relation between disease asymmetry and severity in keratoconus. Br J Ophthalmol 2004;88(6):788−791. DOI: 10.1136/bjo.2003.034520.
  3. Li X, Rabinowitz YS, Rasheed K, et al. Longitudinal study of the normal eyes in unilateral keratoconus patients. Ophthalmology 2004;111(3):440−446. DOI: 10.1016/j.ophtha.2003.06.020.
  4. Jones-Jordan LA, Walline JJ, Sinnott LT, et al. Asymmetry in keratoconus and vision-related quality of life. Cornea 2013;32(3):267−272. DOI: 10.1097/ICO.0b013e31825697c4.
  5. Gordon-Shaag A, Millodot M, Shneor E, et al. The genetic and environmental factors for keratoconus. Biomed Res Int 2015;2015:795738. DOI: 10.1155/2015/795738.
  6. Flockerzi E, Xanthopoulou K, Goebels SC, et al. Keratoconus staging by decades: A baseline ABCD classification of 1000 patients in the Homburg Keratoconus Center. Br J Ophthalmol 2021;105(8):1069−1075. DOI: 10.1136/bjophthalmol-2020-316789.
  7. Hashemi H, Heydarian S, Hooshmand E, et al. The prevalence and risk factors for keratoconus: A systematic review and meta-analysis. Cornea 2020;39(2):263−270. DOI: 10.1097/ICO.0000000000002150.
  8. Al-Mahrouqi HH, Al-Shamli N, Mohan NR, et al. Clinical profile of Omani keratoconus patients: An experience from a tertiary referral centre in Muscat. Oman J Ophthalmol 2018;11(3):259−264. DOI: 10.4103/ojo.OJO_203_2017.
  9. Netto EAT, Al-Otaibi WM, Hafezi NL, et al. Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia. Br J Ophthalmol 2018;102(10):1436−1441. DOI: 10.1136/bjophthalmol-2017-311391.
  10. Althomali TA, Al-Qurashi IM, Al-Thagafi SM, et al. Prevalence of keratoconus among patients seeking laser vision correction in Taif area of Saudi Arabia. Saudi J Ophthalmol 2018;32:114−118. DOI: 10.1016/j.sjopt.2017.11.003.
  11. Al Saidi R, Almahroqi H, Bandara A, et al. Prevalence of keratoconus among young adults in Oman: A cross-sectional study using retinoscopy and corneal tomography. Int J Kerat Ect Cor Dis 2023;10(1−2):20−25. DOI: 10.5005/jp-journals-10025-1195.
  12. Deshmukh R, Ong ZZ, Rampat R, et al. Management of keratoconus: An updated review. Front Med (Lausanne) 2023;10:1212314. DOI: 10.3389/fmed.2023.1212314.
  13. Raiskup F, Spoerl E. Corneal crosslinking with riboflavin and ultraviolet A. I. Principles. Ocul Surf 2013;11(2):65−74. DOI: 10.1016/j.jtos.2013.01.002.
  14. Hersh PS, Stulting RD, Muller D, et al. United States multicenter clinical trial of corneal collagen crosslinking for keratoconus treatment. Ophthalmology 2017;124(9):1259−1270. DOI: 10.1016/j.ophtha.2017.03.052.
  15. Wollensak G. Crosslinking treatment of progressive keratoconus: New hope. Curr Opin Ophthalmol 2006;17(4):356−360. DOI: 10.1097/01.icu.0000233954.86723.25.
  16. Matthys A, Cassagne M, Galiacy SD, et al. Transepithelial corneal cross-linking with supplemental oxygen in keratoconus: 1-year clinical results. J Refract Surg 2021;37(1):42−48. DOI: 10.3928/1081597X-20201111-01.
  17. Arance-Gil A, Villa-Collar C, Perez-Sanchez B, et al. Epithelium-off vs. transepithelial corneal collagen crosslinking in progressive keratoconus: 3 years of follow-up. J Optom 2021;14(2):189−198. DOI: 10.1016/j.optom.2020.07.005.
  18. D’Oria F, Palazon A, Alio JL. Corneal collagen cross-linking epithelium-on vs. epithelium-off: A systematic review and meta-analysis. Eye Vis (Lond) 2021;8(1):34. DOI: 10.1186/s40662-021-00256-0.
  19. Balidis M, Koronis S, de Politis PB, et al. Two-year outcomes of transepithelial customized cross-linking for mild to moderate keratoconus. Int J Kerat Ect Cor Dis 2023;10(1–2):26–31. DOI: 10.5005/jp-journals-10025-1196.
  20. Hill J, Liu C, Deardorff P, et al. Optimization of oxygen dynamics, UV-A delivery, and drug formulation for accelerated epi-on corneal crosslinking. Curr Eye Res 2020;45(4):450–458. DOI: 10.1080/02713683.2019.1669663.
  21. Lim WK, Soh ZD, Choi HKY, et al. Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia. Clin Ophthalmol 2017;11:1205–1211. DOI: 10.2147/OPTH.S137712.
  22. Seiler TG, Fischinger I, Koller T, et al. Customized corneal cross-linking: One-year results. Am J Ophthalmol 2016;166:14–21. DOI: 10.1016/j.ajo.2016.02.029.
  23. Kluger R, Alagic A. Chemical cross-linking and protein-protein interactions – A review with illustrative protocols. Bioorg Chem 2004;32(6):451–472. DOI: 10.1016/j.bioorg.2004.08.002.
  24. Roberts CJ, Dupps Jr WJ. Biomechanics of corneal ectasia and biomechanical treatments. J Cataract Refract Surg 2014;40(6):991–998. DOI: 10.1016/j.jcrs.2014.04.013.
  25. Lang PZ, Hafezi NL, Khandelwal SS, et al. Comparative functional outcomes after corneal crosslinking using standard, accelerated, and accelerated with higher total fluence protocols. Cornea 2019;38(4):433–441. DOI: 10.1097/ICO.0000000000001878.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.