核黄素/UVA诱导的角膜交联术治疗晚期圆锥角膜的安全性和有效性

doi:10.6040/j.issn.1673-3770.0.2014.338

Abstract

Abstract: Objective To evaluate the efficacy and safety of UVA/riboflavin corneal crosslinking in late keratoconus cases with cornea thinner than 400 μm. Methods A total of 18 eyes of 14 keratoconus patients with corneal thickness less than 400 μm were recruited in this study. Corneal epithelium of central 8mm was removed mechanically under topical anesthesia, then hypo-osmotic riboflavin was applied until corneal thickness reached over 400 μm. Then standard UVA/riboflavin corneal crosslinking was applied. BCVA, apex K value, corneal thickness, endothelium and lens changes were examined and recorded. Results Corneal epithelium of all patients was recovered within 1 week, and it of 14 eyes within 5 days. Corneal haze was found in all patients and vanished in 2 to 6 weeks. BCVA was 4.76±0.61 before treatment and 4.83±0.46 and 4.84±0.51 on 3 and 6 months after the operation. Apex K value was 56.29±7.33D, 52.42±5.76D and 48.12±6.6D before the treatment, and 3 and 6 months after the treatment. Corneal thickness was 318±33 μm, 447±18 μm, 381±72 μm and 354±35 μm before the treatment, after swelling, and 3 and 6 months after crosslinking. Endothelium was 3 069±202/mm², 2 910±213/mm² and 2 935±215/mm² before the treatment, and 3 and 6 months after the treatment. Conclusion By using hypo-osmotic riboflavin to swell thin cornea, UVA/riboflavin corneal crosslinking is safe and effective in the treatment of late keratoconus.

Key words: Corneal thickness, Corneal endothelium, Keratoconus, UVA/riboflavin corneal crosslinking

CLC Number:

R772.2

ZHANG Chun-xiao, LI Zhi-wei, XU Wen-wen, LI Feng-jiao, TAO Xiang-chen, MU Guo-ying. Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus[J].JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(2): 86-88.

References

[1] Yeung S N, Ku J Y, Lichtinger A, et al. Efficacy of single or paired intrastromal corneal ring segment implantation combined with collagen crosslinking in keratoconus[J]. J Catar Refract Surg, 2013, 39(8) :1146-1151.
[2] Caporossi A, Mazzotta C, Baiocchi S, et al. Ribo- flavin-UVA-induced corneal collagen crosslinking in pediatric patients[J]. Cornea, 2012, 31(3):227-231.
[3] Tahzib N G, van der Leij A G. Corneal crosslinking as treatment for progressive keratoconus[J]. Ned Tijdschr Geneeskd, 2011, 155(34): A3304.
[4] Soeters N, Van der Lelij A, van der Valk R, et al. Corneal crosslinking for progressive keratoconus in four children[J]. J Pedia Ophthalmol Strab, 2011, 48 Online:e26-29.
[5] Sloot F, Soeters N, van der Valk R, et al. Effective corneal collagen crosslinking in advanced cases of progressive keratoconus[J]. J Catar Refract Surg, 2013, 39(8):1141-1145.
[6] Saffarian L, Khakshoor H, Zarei-Ghanavati M, et al. Corneal Crosslinking for Keratoconus in Iranian Patients: Outcomes at 1 year following treatment[J]. Mid East Af J Ophthalmol, 2010, 17(4):365-368.
[7] Kymionis G, Portaliou D. Corneal crosslinking with riboflavin and UVA for the treatment of kera- toconus[J]. J Catar Refract Surg, 2007, 33(7):1143-1144.
[8] Stanca H T, Manea G. Corneal crosslinking protocols in keratoconus[J]. Oftalmologia, 2012, 56(2):25-29.
[9] 崔长霞, 朱伟, 张春晓, 等. 核黄素/UVA诱导的角膜交联术治疗真菌性角膜溃疡[J]. 山东大学耳鼻喉眼学报, 2013, 27(5):68-70. CUI Changxia, ZHU Wei, ZHANG Chunxiao, et al. Riboflavin/UVA-induced corneal crosslinking in the treatment of fungal corneal ulceration[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(5):68-70.
[10] Caporossi A, Mazzotta C, Paradiso A L, et al. Trans-epithelial corneal collagen crosslinking for progressive keratoconus:24-month clinical results[J]. Catar Refract Surg, 2013, 39(8):1157-1163.
[11] Grewal D S, Brar G S, Jain R, et al. Corneal collagen crosslinking using riboflavin and ultraviolet-A light for keratoconus: one-year analysis using Scheimpflug imaging[J]. J Catar Refract Surg, 2009, 35(3):425-432.
[12] Hersh P S, Greenstein S A, Fry K L. Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results[J]. J Catar Refract Surg, 2011, 37(7):1282-1290.
[13] Kymionis G D, Grentzelos M A, Kounis G A, et al. Intraocular pressure measurements after corneal colla-gen crosslinking with riboflavin and ultra- violet A in eyes with keratoconus[J]. J Catar Refract Surg, 2010, 36(10):1724-1727.
[14] Guber I, Guber J, Kaufmann C, et al. Visual recovery after corneal crosslinking for keratoconus: a 1-year follow-up study[J]. Ophthalmologie, 2013, 251(3):803-807.
[15] Daxer A, Mahmoud H A, Venkateswaran R S. Corneal crosslinking and visual rehabilitation in keratoconus in one session without epithelial debridement: new technique[J]. Cornea, 2010, 29(10):1176-1179.
[16] Greenstein S A, Shah V P, Fry K L, et al. Corneal thickness changes after corneal collagen cross linking for keratoconus and corneal ectasia: one-year results[J]. J Catar Refract Surg, 2011, 37(4):691-700.
[17] Hassan Z, Szalai E, Modis L, et al. Assessment of corneal topography indices after collagen cross linking for keratoconus[J]. Europ J Ophthalmol, 2013, 23(5):635-640.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 0

No Suggested Reading articles found!

Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus

PDF (PC)

Abstract

Cite this article

share this article

References

Related Articles 5

Metrics

Comments

Recommended 0

[1]	ZHANG Xiao, JIANG Liangzhu, XU Yanyun, MU Guoying. The result of riboflavin/UVA corneal collagen cross-linking with isotonic riboflavin solution and hypotonic riboflavin solution in the treatment of keratoconus. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 87-90.
[2]	JIANG Yang1, QIU Jia-ji2, JIN Yu-mei1, LI Ying1. Application of ocular response analyzer in the intraocular pressure measurement [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(4): 58-60.
[3]	YANG Xue-qiu1, ZHAO Jing-jing1, ZHUANG Wen-juan2. Measurements of corneal thickness in the clinic [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(2): 80-82.
[4]	LEI Yu-lin1, ZHENG Xiu-yun1, DANG Guang-fu2, LIU Su-mei1. Comparison of corneal thickness measurements using pentacam, orbscan II, and A-ultrasonic pachymetry in myopia [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2011, 25(2): 89-91.
[5]	HU Ming,LI Zhao-na,LI Yun-jie ,TAO Xiang-chen . Effect of rigid gas permeable contact lens on keratoconus [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(2): 171-173 .