Document Detail

Optical coherence tomography and confocal microscopy following 3 different protocols of corneal collagen-crosslinking in keratoconus.
MedLine Citation:
PMID:  25352122     Owner:  NLM     Status:  Publisher    
Purpose: To compare the efficacy and early morphological changes in the cornea following conventional (C-CXL), transepithelial by iontophoresis (I-CXL), and accelerated collagen cross-linking (A-CXL) in keratoconus. Methods: 45 eyes of 45 patients with progressive keratoconus who underwent corneal collagen crosslinking (CXL) were divided into 3 groups: C-CXL (n=15), A-CXL (n=15) and I-CXL (n=15). Patients were examined before surgery and at 1-month, 3-month, and 6-month intervals following surgery. Density of corneal sub-basal nerves, anterior and posterior keratocytes, corneal endothelium, demarcation line depth and maximal simulated keratometry values (Kmax) were all assessed. Results: Compared with preoperative values, the mean corneal sub-basal nerve and anterior stromal keratocyte densities were significantly lower at 6 months in the C-CXL and the A-CXL groups (p<0.001) whereas they returned to preoperative values in the I-CXL group (p=0.083 and p=0.909, respectively). The corneal demarcation line was visible 1 month after surgery in 93% of cases (mean depth, 302.8+74.6 µm) in the C-CXL group, in 87.5% (mean depth, 184. 2+38.9 µm) in the A-CXL group, and in 47.7% (mean depth, 212+36.5 µm) in the I-CXL group (p=0.006). There were no significant differences between confocal microscopy and optical coherence tomography measurements of the corneal demarcation line depth (p>0.05). Kmax, corneal central thickness, and BSCVA remained stable during the whole study period. Conclusion: Iontophoresis was associated with weaker damage of corneal sub-basal nerves and anterior keratocytes compared with conventional procedures, but the demarcation line was present in less than 50% of cases and was more superficial than with the traditional procedure.
Nacim Bouheraoua; Lea Jouve; Mohamed El Sanharawi; Otman Sandali; Cyrille Temstet; Patrick Loriaut; Elena Basli; Vincent Borderie; Laurent Laroche
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-28
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  -     ISSN:  1552-5783     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-29     Completed Date:  -     Revised Date:  2014-10-30    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 by Association for Research in Vision and Ophthalmology.
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