Repeated Corneal Cross-Linking with Progressive Keratoconus

Ophthalmology in Russia, Год журнала: 2019, Номер 16(1S), С. 56 - 60

Опубликована: Апрель 22, 2019

The purpose is to study the efficacy and safety of repeated UV corneal crosslinking in patients with advanced keratoconus after transepithelial performed previously. Patients methods . A retrospective analysis treatment results 52 (52 eyes) progressive stage I-II according Amsler — Krumeich classification, which from 2012 2014 were treated by crosslinking. Based on objective clinical studies, effectiveness course process evaluated. In some a (12 eyes), crosslinking, procedure cornea was standard protocol. Results After cross-linking within 24 months 12 eyes (44 %) progression disease observed, manifested an increase refractive power 0.95 ± 0.18 D, decrease thickness 484 156 446 87 microns. Repeated 6 positive dynamics observed 10 cases (83.3 %), visual acuity reached preoperative level, 50.3 0.84 D. Stabilization noted all eyes, average index 1.1 1.25 astigmatism 1.2 0.31 427 38.7 mc. Conclusion use modified protocols, particular iontophoresis, has lower efficiency, showing stabilization 56 % cases, compared standard, must be considered when choosing approach selecting patients. Performing recrosslinking using protocol showed high efficiency 100 however, this should studied larger number observations.

Язык: Английский

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Evaluating the Effectiveness of Accelerated and Accelerated Cornea Pulsing Crosslinking Based on the Presence of a Demarcation Line

Ophthalmology in Russia, Год журнала: 2019, Номер 16(1S), С. 127 - 131

Опубликована: Апрель 22, 2019

Purpose of the study is to assess state demarcation line stroma after accelerated and pulsed ultraviolet cornea crosslinking. Patients methods . Clinical observations included 24 patients (31 eyes) with keratoconus (KC), aged 18–46 years, men — 11 (45.9 %), women 13 (54.1 %). Accelerated (a-CXL) crosslinking was carried out in continuous mode a power 18 mW/cm2 for 5 minutes (13 eyes), (i-ACXL) 10 minutes, 1 sec light / pause (18 eyes). Conducted generally accepted additional ophthalmic research. The follow-up periods were 1, 3, 6 months surgery. Results According optical coherent tomography, detected all cases a-CXL i-ACXL. At month crosslinking, there no significant differences between i-ACXL groups terms uncorrected visual acuity, corrected maximal correction. average depth at procedure central zone 216.41 ± 36.67 μm group 236.41 37.08 group. Using confocal microscopy vivo both surgery apoptosis keratocytes stromal edema detected. A gradual restoration its original observed months. Conclusion Research results have shown that cross-linking are safe effective technologies stabilize progression keratoconus. Both protocols provide reduction duration compared traditional one. Revealed deeper arrangement when performing accelerated. Further long-term more extensive studies will improved information on their effectiveness long-term.

Язык: Английский

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On the Possibility of Stabilization of a Contracted State after Riboflavin/UV Cross-Linking of Collagenous Tissue in a Partially Dehydrated State

Izvestiya of Saratov University Physics, Год журнала: 2019, Номер 19(3), С. 210 - 222

Опубликована: Янв. 1, 2019

О возможности стабилизации контрактированного состояния коллагенсодержащих тканей в результате рибофлавин/УФ кросслинкинга при пониженном уровне гидратации ткани

Язык: Русский

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Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review

Acta Biomedica Scientifica (East Siberian Biomedical Journal), Год журнала: 2020, Номер 5(5), С. 73 - 80

Опубликована: Ноя. 9, 2020

Ultraviolet crosslinking is a pathogenetically oriented method of treating primary and secondary corneal ectasias that cause irregular astigmatism visual impairment. Advanced stage the disease, when initial thickness cornea below 400 mc, contraindication to use standard «Dresden» protocol procedure. In such cases, it possible modified UV protocols. This article presents modern methods used for progressive keratoconus in advanced stages with thin cornea. The presented are combined taking into account principled approaches – using additional tools without them. Both based on temporary artificial increase during procedure order reduce likelihood damage deep layers evolution protocols corneas began hypoosmolar solutions safe values. However, an approach was not stable change pachymetry parameters created difficulties its standardization. different staff by providing layer like contact or biological lens seemed more encouraging. At same time, low permeability these oxygen, much needed process macromolecules, limited overall effectiveness As result development technologies improvement devices, logical continuation trend modifying introduction individual customization protocol. described protocols, principles surgical ultraviolet radiation, set forth results, evaluate their safety applied patients

Язык: Английский

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Ultraviolet crosslinking of corneal collagen in patients with thin cornea. Literature review

Acta Biomedica Scientifica (East Siberian Biomedical Journal), Год журнала: 2021, Номер 6(6-1), С. 229 - 236

Опубликована: Дек. 28, 2021

For the treatment of progressive keratoconus in early stages, corneal collagen crosslinking is currently actively used. This technique based on stabilization pathological process by increasing biomechanical properties own cornea. The thickness cornea less than 400 microns significantly limits possibility a standard cross-linking procedure performing.The article analyzes literature data use various methods with microns, which signifi cantly possibilities procedure.It known, that during crosslinking, at initial stage, de-epithelialization performed, which, postoperative period, leads to pronounced syndrome. determined direction fi rst modifi cations associated partial or its complete absence. Later, “thin” corneas, techniques additional covering materials were used order replenish missing tissue patient UV irradiation procedure. Among them are soft contact lens without an ultraviolet lter, lenticule obtained after SMILE surgery, protective fl ap donor using femtosecond laser from residual stroma disc descemet membrane transplantation posterior lamellar keratoplasty. variety proposed modifications and ongoing search for better options indicate demand this technology need further research, taking into account individual characteristics patient’s ectasia.

Язык: Английский

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