International Journal of Keratoconus and Ectatic Corneal Diseases

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
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 6 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

To evaluate the Role and Efficacy of Collagen Cross-linkage with Ultraviolet Therapy following Riboflavin Drops with Orbscan in Cases of Progressive Keratoconus

Parmod Guleria, Vikas Sharma

Citation Information : Guleria P, Sharma V. To evaluate the Role and Efficacy of Collagen Cross-linkage with Ultraviolet Therapy following Riboflavin Drops with Orbscan in Cases of Progressive Keratoconus. Int J Kerat Ect Cor Dis 2017; 6 (2):67-72.

DOI: 10.5005/jp-journals-10025-1145

License: CC BY 3.0

Published Online: 01-09-2017

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

To evaluate the role and efficacy of collagen cross-linkage with riboflavin (C3R) in cases of progressive keratoconus.

Study design

Prospective, nonrandomized, single-center clinical study.

Materials and methods

The C3R was done in 32 eyes of 21 patients with at least 6 months of documented progression. Outcome of the procedure was measured by means of uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), corneal topography with Orbscan changes in posterior best fit sphere (PBFS), ratio of anterior and posterior best fit sphere (ABFS/PBFS), astigmatic changes in central 3- and 5-mm zone, central endothelial count postcorneal C3R.

Results

Thirty-two eyes with a follow-up of 6 months were analyzed. The mean age was 19.8 years. The preoperative values on the day of treatment were compared with postoperative values after the 6-month examination. The improvement in UCVA and BSCVA was statistically significant (p = 0.02 and 0.01 respectively). The change in power for PBFS was not statistically significant (p = —0.08). There was no significant difference in corneal endothelial counts pre- and post-C3R (p = 0.058). Mean value pre-C3R for ratio of ABFS/PBFS was 1.25 ± 3.7 and post-C3R was 1.22 ± 1.8 (p = 0.00). Mean value of astigmatism in 3-mm zone pre- and post-C3R was —4.3 ± 0.98 and —3.9 ± 0.66(p = 0.046) respectively. Mean value pre-C3R for astigmatism in 5-mm zone was —4.9 ± 1.91 and post-C3R was —4.0 ± 0.82 (p = 0.02).

Conclusion

The results show a stabilization and improvement in keratoconus after C3R in Indian eyes.

How to cite this article

Guleria P, Sharma V. To evaluate the Role and Efficacy of Collagen Cross-linkage with Ultraviolet Therapy following Riboflavin Drops with Orbscan in Cases of Progressive Keratoconus. Int J Kerat Ect Cor Dis 2017;6(2):67-72.

HTML PDF Share
  1. The immuno histochemical composition of corneal basement membrane in keratoconus. Curr Eye Res 1997 Aug;16(8):792-801.
  2. Expression of type XII collagen and hemidesmosomes-associated proteins in keratoconus corneas. Curr Eye Res 2001 May;22(5):333-340.
  3. Biochemical properties of keratoconus corneas. Exp Eye Res 1980 Oct;31(4):435-441.
  4. Keratoconus. Surv Ophthalmol 1998 Jan-Feb;42(4):297-319.
  5. Corneal thickness indices discriminate between keratoconus and contact lens induced corneal thickening. Ophthalmology 2002 Dec;109(12):2336-2241.
  6. The ocular examination: measurements and findings. Philadelphia: W.B. Saunders; 1997.
  7. Estimation of the incidence and factors predictive of corneal scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study. Cornea 2006 Jan;25(1):16-25.
  8. Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res 2004 Jul;29(1):35-40.
  9. Inflammatory response to contact lenses in patients with keratoconus compared with myopic subjects. Cornea 2008 Aug;27(7):758-763.
  10. Safety of UVA - riboflavin cross-linking of the cornea. Cornea 2007 May;26(4):385-389.
  11. Manifest diabetes and keratoconus: a retrospective case-control study. Graefes Arch Clin Exp Ophthalmol 2000 Oct;238(10):822-825.
  12. Riboflavin /ultraviolet-a-induced C3R for the treatment of keratoconus. Am J Ophthalmol 2003 May;135(5):620-627.
  13. Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet-A-induced cross-linking. J Cataract Refract Surg 2003 Sep;29(9):1780-1785.
  14. Corneal topography guided penetrating keratoplasty and suture adjustment: new approach for astigmatism control. Cornea 2007 Jul;26(6):675-682.
  15. Cross linking treatment of progressive keratoconus: new hope. Curr Opin Ophthalmol 2006 Aug;17(4):356-360.
  16. How might corneal elasticity help us understand diabetes and intraocular pressure? J Refract Surg 2007 Jan; 23(1):85-88.
  17. Nonenzymatic glycation of collagen in aging and diabetes. Proc Soc Exp Biol Med 1991 Jan;196(1):17-29.
  18. 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 May;32(5):837-845.
  19. Collagen cross-linking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg 2008 May;34(5):796-801.
  20. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology 2009 Mar;116(3):369-378.
  21. Biomechanical evidence of the distribution of cross-links in corneas treated with riboflavin and ultraviolet A light. J Cataract Refract Surg 2006;32(2):279-283.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.