1. [Corneal Cross-linking for the treatment of keratoconus: preliminary results].
- Author
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Jankov MR 2nd, Hafezi F, Beko M, Ignjatovic Z, Djurovic B, Markovic V, and Schor P
- Subjects
- Adult, Collagen drug effects, Collagen metabolism, Collagen radiation effects, Female, Follow-Up Studies, Humans, Male, Middle Aged, Refraction, Ocular drug effects, Refraction, Ocular radiation effects, Treatment Outcome, Visual Acuity drug effects, Visual Acuity radiation effects, Corneal Stroma drug effects, Corneal Stroma metabolism, Corneal Stroma radiation effects, Keratoconus drug therapy, Keratoconus radiotherapy, Photochemotherapy methods, Photosensitizing Agents therapeutic use, Riboflavin therapeutic use, Ultraviolet Therapy
- Abstract
Purpose: To present early visual and keratometric results for corneal cross-linking with riboflavin and UV irradiation in patients with progressive keratoconus., Methods: Twenty-five eyes of twenty patients (15 males and 5 females) with a progressive keratoconus in the previous 6 months were followed. Unaided visual acuity (UVA), best spectacle corrected visual acuity (BSCVA), spherical equivalent (SEQ), manifest cylinder, and maximal corneal curvature (max K) values were followed at 1, 3 and 6 months. All patients were submitted to corneal cross-linking using riboflavin (vitamin B2) as the photosensitizer and ultraviolet light (UV, wavelength 370 nm). Epithelium was removed with 20% alcohol, cornea was soaked with vitamin B2 for 15 min, and then irradiated with UV light for 30 min, after which a bandage contact lens (BCL) was placed., Results: UVA increased after one month (from 0.15 +/- 0.15 to 0.23 +/- 0.20), and went on increasing at 3 and 6 months, reaching statistical significance (p=0.025 e p=0.037, respectively). BSCVA increased from 0.41 +/- 0.27 to 0.49 +/- 0.29 at month six, without reaching statistical significance at any time point. Progression of keratoconus stopped in all patients, in contrast with progression in all of them in the six-month period prior to the surgery. Max K decreased by more than 2 D (from 53.02 +/- 8.42 to 50.88 +/- 6.05 D), SEQ less that 1 D (from -3.27 +/- 4.08 to -2.68 +/- 3.02 D), while refractive cylinder decreased less than 0.5 D (from -2.29 +/- 1.77 to -1.86 +/- 0.92 D), without reaching a statistically significant difference. None of the eyes lost any line of BSCVA, 12 maintained the preoperative BSCVA, 7 gained one line, 5 gained two lines, and 1 patient gained three lines of BSCVA., Conclusions: Corneal cross-linking with riboflavin and UV light seems to be a safe (no loss of BSCVA) and effective (anatomical and optical properties maintained) procedure, which has shown to stop the progression of the keratoconus: a reduction, although not statistically significant, of the corneal curvature, spherical equivalent and refractive cylinder took place in patients where previous progression of keratoconus had been described.
- Published
- 2008
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