Limits...
Corneal haze and visual outcome after collagen crosslinking for keratoconus: A comparison between total epithelium off and partial epithelial removal methods.

Razmjoo H, Rahimi B, Kharraji M, Koosha N, Peyman A - Adv Biomed Res (2014)

Bottom Line: Both methods had significant and similar increase in optical corneal density (P < 0.0001).In our study, keeping the central corneal epithelium intact was not beneficial for decreasing corneal haziness, however, this method caused better improvement in corrected vision.Total epithelium off technique resulted in better improvement of K-max and Q-value.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Keratoconus is an asymmetric, bilateral, progressive noninflammatory ectasia of the cornea that affects approximately 1 in 2000 of the general population. This may cause a significant negative impact on quality of life. Corneal collagen crosslinking (CXL) is one of the recently introduced methods that have been used to decrease the progression of keratoconus, in particular, as well as other corneal-thinning processes.

Materials and methods: A total of 44 keratoconic eyes of 22 patients were enrolled in this randomized prospective study, after obtaining informed consent. In the first group, the corneal epithelium were totally removed and in the second group, the central 3 mm of epithelium was kept intact and partial removal was performed. After collagen crosslinking in both groups, comprehensive ophthalmologic examination was performed on all patients before and 6 months after the surgery. This article is registered at www.clinicaltrial.gov with registration number NCT01809977.

Results: The difference between the two groups was not statistically significant regarding postoperative corneal haziness, refraction, and visual acuity (P > 0.05). However, comparison of pre- and postoperative parameters within each group revealed that total removal of the cornea has resulted in significant improvement of K-max (P value: 0.01) and Q-value (P value: 0.009); while eyes in partial removal group had better improvement of corrected vision (P value: 0.006). Both methods had significant and similar increase in optical corneal density (P < 0.0001).

Conclusion: In our study, keeping the central corneal epithelium intact was not beneficial for decreasing corneal haziness, however, this method caused better improvement in corrected vision. Total epithelium off technique resulted in better improvement of K-max and Q-value.

No MeSH data available.


Related in: MedlinePlus

Schematic comparison of 2 surgical methods
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4260293&req=5

Figure 2: Schematic comparison of 2 surgical methods

Mentions: The CXL procedure was performed under sterile condition. In order to reduce the risk of retinal and lens damage, all patients received Pilocarpine (eye drop 2%) preoperatively. Then, topical anesthesia was administered, and the corneal epithelium was removed by mechanical debridement. In the first group, total removal was performed by mechanical debridement of the corneal epithelium over the central 9 mm. In the second group, partial removal was performed by removing a 3 mm width ring and leaving the central 3 mm of the cornea intact [Figure 2]. Then, riboflavin (0.1% in 20% dextran solution) was administered topically every minute for 30 minutes. After that, a slit-lamp examination was performed to confirm riboflavin absorption throughout the corneal stroma and anterior chamber. Thereafter, 3 mW/cm2 ultraviolet-A (370 nm wavelength UVA) corresponding to a surface dose of 5.4 J/cm2) irradiation was applied to the cornea for 30 minutes at a working distance of 5 cm. AIROC UV-X™ 1000 device (IROC Innocross AG, Switzerland) was used as the UVA radiation source. During the procedure, riboflavin solution and topical anesthetic agent were administered every 2-3 minutes to moisten the cornea and to saturate it with riboflavin. Subsequently, a therapeutic contact lens was placed after the operation and maintained for 7 days.


Corneal haze and visual outcome after collagen crosslinking for keratoconus: A comparison between total epithelium off and partial epithelial removal methods.

Razmjoo H, Rahimi B, Kharraji M, Koosha N, Peyman A - Adv Biomed Res (2014)

Schematic comparison of 2 surgical methods
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260293&req=5

Figure 2: Schematic comparison of 2 surgical methods
Mentions: The CXL procedure was performed under sterile condition. In order to reduce the risk of retinal and lens damage, all patients received Pilocarpine (eye drop 2%) preoperatively. Then, topical anesthesia was administered, and the corneal epithelium was removed by mechanical debridement. In the first group, total removal was performed by mechanical debridement of the corneal epithelium over the central 9 mm. In the second group, partial removal was performed by removing a 3 mm width ring and leaving the central 3 mm of the cornea intact [Figure 2]. Then, riboflavin (0.1% in 20% dextran solution) was administered topically every minute for 30 minutes. After that, a slit-lamp examination was performed to confirm riboflavin absorption throughout the corneal stroma and anterior chamber. Thereafter, 3 mW/cm2 ultraviolet-A (370 nm wavelength UVA) corresponding to a surface dose of 5.4 J/cm2) irradiation was applied to the cornea for 30 minutes at a working distance of 5 cm. AIROC UV-X™ 1000 device (IROC Innocross AG, Switzerland) was used as the UVA radiation source. During the procedure, riboflavin solution and topical anesthetic agent were administered every 2-3 minutes to moisten the cornea and to saturate it with riboflavin. Subsequently, a therapeutic contact lens was placed after the operation and maintained for 7 days.

Bottom Line: Both methods had significant and similar increase in optical corneal density (P < 0.0001).In our study, keeping the central corneal epithelium intact was not beneficial for decreasing corneal haziness, however, this method caused better improvement in corrected vision.Total epithelium off technique resulted in better improvement of K-max and Q-value.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.

ABSTRACT

Background: Keratoconus is an asymmetric, bilateral, progressive noninflammatory ectasia of the cornea that affects approximately 1 in 2000 of the general population. This may cause a significant negative impact on quality of life. Corneal collagen crosslinking (CXL) is one of the recently introduced methods that have been used to decrease the progression of keratoconus, in particular, as well as other corneal-thinning processes.

Materials and methods: A total of 44 keratoconic eyes of 22 patients were enrolled in this randomized prospective study, after obtaining informed consent. In the first group, the corneal epithelium were totally removed and in the second group, the central 3 mm of epithelium was kept intact and partial removal was performed. After collagen crosslinking in both groups, comprehensive ophthalmologic examination was performed on all patients before and 6 months after the surgery. This article is registered at www.clinicaltrial.gov with registration number NCT01809977.

Results: The difference between the two groups was not statistically significant regarding postoperative corneal haziness, refraction, and visual acuity (P > 0.05). However, comparison of pre- and postoperative parameters within each group revealed that total removal of the cornea has resulted in significant improvement of K-max (P value: 0.01) and Q-value (P value: 0.009); while eyes in partial removal group had better improvement of corrected vision (P value: 0.006). Both methods had significant and similar increase in optical corneal density (P < 0.0001).

Conclusion: In our study, keeping the central corneal epithelium intact was not beneficial for decreasing corneal haziness, however, this method caused better improvement in corrected vision. Total epithelium off technique resulted in better improvement of K-max and Q-value.

No MeSH data available.


Related in: MedlinePlus