Document Detail

Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus.
MedLine Citation:
PMID:  22633357     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report refractive, topographic, aberrometric, and tomographic outcomes 24 months after corneal cross-linking (CXL) in patients up to 18 years of age with progressive keratoconus.
DESIGN: Prospective, interventional case series.
METHODS: Forty eyes underwent riboflavin-ultraviolet A-induced CXL. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), sphere and cylinder, topography, aberrometry, tomography, and endothelial cell counts were evaluated at baseline and at 1, 3, 6, 12, and 24 months.
RESULTS: Mean logarithm of the minimum angle of resolution baseline UCVA and BSCVA were 0.79 ± 0.21 and 0.39 ± 0.10, respectively. Mean UCVA and BSCVA at 2 years were 0.58 ± 0.18 and 0.20 ± 0.09, respectively. The improvement in UCVA and BSCVA was significant throughout the postoperative follow-up (P < .05). Mean spherical equivalent refraction showed a significant decrease of 1.57 diopters (D) at 24 months (P = .02). Mean baseline simulated keratometry was 46.32 D in the flattest meridian and 51.48 D in the steepest meridian; at 2 years, the values were 45.30 D (P = .04) and 50.21 D (P = .07), respectively. For a 3-mm pupil, there was a significant reduction (P < .05) in whole eye (total), corneal, higher-order, and astigmatic wavefront aberrations at 24 months. A significant difference (P < .05) in total coma and total spherical aberration 2 years after CXL also was observed. Mean baseline pupil center pachymetry decreased significantly (P = .04) at 6 months, but recovered by 12 months and remained stable thereafter through the 2-year follow-up. Endothelial cell counts did not change significantly (P = .32).
CONCLUSIONS: CXL improved UCVA and BSCVA in the study patients, most likely by significantly reducing corneal asymmetry and corneal as well as total wavefront aberrations.
Paolo Vinciguerra; Elena Albé; Beatrice E Frueh; Silvia Trazza; Daniel Epstein
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Publication Detail:
Type:  Journal Article     Date:  2012-05-24
Journal Detail:
Title:  American journal of ophthalmology     Volume:  154     ISSN:  1879-1891     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-17     Completed Date:  2012-11-06     Revised Date:  2013-03-21    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milano, Italy.
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MeSH Terms
Cell Count
Collagen / metabolism*
Corneal Stroma / metabolism*
Corneal Topography
Cross-Linking Reagents / therapeutic use*
Disease Progression
Endothelium, Corneal / pathology
Keratoconus / diagnosis,  drug therapy*,  metabolism,  physiopathology
Photosensitizing Agents / therapeutic use
Prospective Studies
Refraction, Ocular / physiology
Riboflavin / therapeutic use
Treatment Outcome
Ultraviolet Rays
Visual Acuity / physiology
Reg. No./Substance:
0/Cross-Linking Reagents; 0/Photosensitizing Agents; 83-88-5/Riboflavin; 9007-34-5/Collagen
Comment In:
Am J Ophthalmol. 2013 Mar;155(3):612-3   [PMID:  23394735 ]

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