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Corneal Confocal Microscopy Following Conventional, Transepithelial, and Accelerated Corneal Collagen Cross-linking Procedures for Keratoconus.
MedLine Citation:
PMID:  23347370     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To compare early corneal healing following conventional, transepithelial, and accelerated corneal collagen cross-linking (CXL) protocols.
METHODS: Twenty-four patients with progressive keratoconus were divided into three groups to receive conventional, transepithelial, or accelerated CXL. In vivo corneal confocal microscopy was performed on each patient preoperatively and at 1, 3, and 6 months postoperatively.
RESULTS: Closure of the epithelial wound was complete 3 days following conventional and accelerated CXL. The subbasal nerve plexus was essentially obliterated immediately following conventional and accelerated CXL, and virtually no nerve fibers had regenerated by 6 months. The anterior stroma showed significant changes 1 month following conventional CXL; these changes were similar but more pronounced following accelerated CXL. Observed stromal changes included complete obliteration of keratocytes, increased tissue reflectivity, a honeycomb-like appearance, and circular lacunae. Some recovery of keratocyte density was noted after 6 months. These changes were less pronounced in the mid-stroma, and there were no apparent changes to the posterior stroma or endothelium. The cornea appeared to be unaltered following transepithelial CXL.
CONCLUSIONS: In vivo corneal confocal microscopy analysis of the postoperative impact of CXL on the cornea revealed clear differences among conventional, accelerated, and transepithelial CXL protocols. Accelerated CXL had a greater impact than conventional CXL on the anterior cornea, whereas transepithelial CXL did not appear to alter corneal morphology.
Authors:
David Touboul; Nathan Efron; David Smadja; Delphine Praud; Florence Malet; Joseph Colin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  28     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  769-76     Citation Subset:  IM    
Copyright Information:
Copyright 2012, SLACK Incorporated.
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