Document Detail


A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results.
MedLine Citation:
PMID:  18811118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This prospective, randomized, controlled trial aims to provide evidence in relation to the efficacy and safety of corneal collagen cross-linking (CXL) in the management of progressive keratoconus. METHODS: Eligible eyes were separately randomized into either treatment or control groups. Collagen crosslinking was performed using 0.1% riboflavin (in 20% dextran T500) and ultraviolet A (UVA) irradiation (370 nm, 3 mW/cm2, 30 min) in accordance with a previously published protocol. At each review, a full clinical ophthalmic examination was performed including endothelial cell count and confocal microscopy. RESULTS: To date, 66 eyes of 49 patients with documented progression of keratoconus have been enrolled and randomized. Interim analysis of treated eyes showed a flattening of the steepest simulated keratometry value (K-max) by an average of 0.74 diopters (D) (P = .004) at 3 months, 0.92 D (P = .002) at 6 months, and 1.45 D (P = .002) at 12 months. A trend toward improvement in best spectacle-corrected visual acuity was also observed. In the control eyes, mean K-max steepened by 0.60 D (P = .041) after 3 months, by 0.60 D (P = .013) after 6 months, and by 1.28 D (P < or = .0001) after 12 months. Best spectacle-corrected visual acuity decreased by logMAR 0.003 (P = .883) over 3 months, 0.056 (P = .092) over 6 months, and 0.12 (P = .036) over 12 months. No statistically significant changes were found for spherical equivalent or endothelial cell density. CONCLUSIONS: Preliminary results of this randomized controlled trial suggest a temporary stabilization of all treated eyes after CXL.
Authors:
Christine Wittig-Silva; Mark Whiting; Ecosse Lamoureux; Richard G Lindsay; Laurie J Sullivan; Grant R Snibson
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  24     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-24     Completed Date:  2008-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S720-5     Citation Subset:  IM    
Affiliation:
Centre for Eye Research Australia, East Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Collagen / metabolism*
Corneal Stroma / drug effects*,  metabolism,  radiation effects
Disease Progression
Female
Humans
Keratoconus / drug therapy*,  metabolism
Male
Microscopy, Confocal
Photochemotherapy*
Photosensitizing Agents / therapeutic use*
Prospective Studies
Riboflavin / therapeutic use*
Treatment Outcome
Ultraviolet Rays
Visual Acuity
Chemical
Reg. No./Substance:
0/Photosensitizing Agents; 83-88-5/Riboflavin; 9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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