TY - JOUR
T1 - Qualitative Investigation of Corneal Changes after Accelerated Corneal Collagen Cross-linking (A-CXL) by In vivo Confocal Microscopy and Corneal OCT
AU - Caporossi, Aldo
AU - Mazzotta, Cosimo
AU - Paradiso, Anna Lucia
AU - Baiocchi, Stefano
AU - Caragiuli, Stefano
PY - 2013
Y1 - 2013
N2 - Purpose: To assess qualitative micro-morphological corneal changes by confocal microscopy and corneal OCT after accelerated corneal crosslinking (A-CXL) in keratoconic patients.
Study design: Prospective non-randomized pilot study.
Methods: 20 eyes of 20 patients, aged between 13 and 26 years (mean 22.6 years) underwent A-CXL by the KXL UV-A source (Avedro Inc. Waltham MA, USA). Patients were divided into 4 groups according to different riboflavin solutions and UV A powers.15 patients underwent epithelium-off A-CXL: 5 (Group 1) by riboflavin 0.1% plus dextran 20% at 12 mW/cm2 for 10 min; 5 (Group 2) at 30 mW/cm2 for 4 min; 5 (Group 3) by dextran-free riboflavin 0.1% plus HPMC at 30 mW/cm2 for 4 min and 5 (Group 4) by riboflavin 0.25% plus EDTA, BAK, TRIS epithelium-on A-CXL for 2 min and 40 sec. Micro-morphological analysis was assessed by in vivo HRT II confocal microscopy and corneal OCT.
Results: Epithelium regenerated into 3 days. Sub-epithelial nerves disappeared after treatment regenerating into 6 months. Epithelium off A-CXL penetration, measured evaluating keratocytes loss at confocal microscopy and demarcation lines at corneal OCT, resulted at 180 μm on average in the Group 1, 160 μm in the Group 2, 150 μm in the Group 3. Epithelium-on A-CXL (Group 4) revealed a penetration at 80 μm on average. No endothelial damage was recorded in all groups.
Conclusion: A-CXL shortened conventional CXL procedure under 20 minutes, being well tolerated. Its clinical efficacy needs to be determined in the mid-long term follow-up and in a large cohort of patients.
AB - Purpose: To assess qualitative micro-morphological corneal changes by confocal microscopy and corneal OCT after accelerated corneal crosslinking (A-CXL) in keratoconic patients.
Study design: Prospective non-randomized pilot study.
Methods: 20 eyes of 20 patients, aged between 13 and 26 years (mean 22.6 years) underwent A-CXL by the KXL UV-A source (Avedro Inc. Waltham MA, USA). Patients were divided into 4 groups according to different riboflavin solutions and UV A powers.15 patients underwent epithelium-off A-CXL: 5 (Group 1) by riboflavin 0.1% plus dextran 20% at 12 mW/cm2 for 10 min; 5 (Group 2) at 30 mW/cm2 for 4 min; 5 (Group 3) by dextran-free riboflavin 0.1% plus HPMC at 30 mW/cm2 for 4 min and 5 (Group 4) by riboflavin 0.25% plus EDTA, BAK, TRIS epithelium-on A-CXL for 2 min and 40 sec. Micro-morphological analysis was assessed by in vivo HRT II confocal microscopy and corneal OCT.
Results: Epithelium regenerated into 3 days. Sub-epithelial nerves disappeared after treatment regenerating into 6 months. Epithelium off A-CXL penetration, measured evaluating keratocytes loss at confocal microscopy and demarcation lines at corneal OCT, resulted at 180 μm on average in the Group 1, 160 μm in the Group 2, 150 μm in the Group 3. Epithelium-on A-CXL (Group 4) revealed a penetration at 80 μm on average. No endothelial damage was recorded in all groups.
Conclusion: A-CXL shortened conventional CXL procedure under 20 minutes, being well tolerated. Its clinical efficacy needs to be determined in the mid-long term follow-up and in a large cohort of patients.
KW - A-CXL
KW - Accelerated cross-linking
KW - Confocal microscopy
KW - Demarcation line
KW - Keratoconus
KW - A-CXL
KW - Accelerated cross-linking
KW - Confocal microscopy
KW - Demarcation line
KW - Keratoconus
UR - http://hdl.handle.net/10807/54208
UR - http://www.omicsonline.org/qualitative-investigation-of-corneal-changes-after-accelerated-corneal-collagen-crosslinking-2155-9570.1000313.php?aid=21602
M3 - Article
VL - Volume 4
SP - N/A-N/A
JO - JOURNAL OF CLINICAL AND EXPERIMENTAL OPHTHALMOLOGYIS
JF - JOURNAL OF CLINICAL AND EXPERIMENTAL OPHTHALMOLOGYIS
SN - 2155-9570
ER -