Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans

Tomaso Caporossi, Aldo Caporossi, Cosimo Mazzotta, Angelo Balestrazzi, Claudio Traversi, Stefano Baiocchi, Cristina Tommasi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

266 Citazioni (Scopus)

Abstract

PURPOSE: To assess ultrastructural stromal modifications after riboflavin-UVA-induced cross-linking of corneal collagen in patients with progressive keratoconus. METHODS: This was a second-phase prospective nonrandomized open study in 10 patients with progressive keratoconus treated by riboflavin-UVA-induced cross-linking of corneal collagen and assessed by means of Heidelberg Retinal Tomograph II Rostock Corneal Module (HRT II-RCM) in vivo confocal microscopy. The eye in the worst clinical condition was treated for each patient. Treatment under topical anesthesia included corneal deepithelization (9-mm diameter) and instillation of 0.1% riboflavin phosphate-20% dextran T 500 solution at 5 minutes before UVA irradiation and every 5 minutes for a total of 30 minutes. UVA irradiation was 7 mm in diameter. Patients were assessed by HRT II-RCM confocal microscopy in vivo at 1, 3, and 6 months after treatment. RESULTS: Rarefaction of keratocytes in the anterior and intermediate stroma, associated with stromal edema, was observed immediately after treatment. The observation at 3 months after the operation detected keratocyte repopulation in the central treated area, whereas the edema had disappeared. Cell density increased progressively over the postoperative period. At approximately 6 months, keratocyte repopulation was complete, accompanied by increased density of stromal fibers. No endothelial damage was observed at any time. CONCLUSIONS: Reduction in anterior and intermediate stromal keratocytes followed by gradual repopulation has been confirmed directly in vivo in humans by HRT II-RCM confocal microscopy after riboflavin-UVA-induced corneal collagen cross-linking.
Lingua originaleEnglish
pagine (da-a)390-397
Numero di pagine8
RivistaCornea
Stato di pubblicazionePubblicato - 2007

Keywords

  • CONFOCAL ANALYSIS
  • CORNEAL CROSS-LINKING
  • HEIDELBERG RETINAL TOMOGRAPH II
  • PROGRESSIVE KERATOCONUS

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