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Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up.
O'Brart, David P S; Patel, Parul; Lascaratos, Gerassimos; Wagh, Vijay K; Tam, Connan; Lee, Jennifer; O'Brart, Naomi A.
Afiliación
  • O'Brart DP; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom. Electronic address: davidobrart@aol.com.
  • Patel P; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom.
  • Lascaratos G; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom.
  • Wagh VK; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom.
  • Tam C; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom.
  • Lee J; Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom.
  • O'Brart NA; School of Optometry, University of Cardiff, Cardiff, United Kingdom.
Am J Ophthalmol ; 160(6): 1154-63, 2015 Dec.
Article en En | MEDLINE | ID: mdl-26307513
PURPOSE: To determine long-term efficacy and safety of riboflavin/ultraviolet A corneal cross-linking (CXL). DESIGN: Prospective cohort study. METHODS: Thirty-six patients (36 eyes) who underwent epithelium-off CXL at a University Hospital (Guy's and St Thomas' National Health Service Foundation Trust) 6-8 years previously were examined. The main outcome measures were refractive error, visual acuity, corneal topographic keratometry, ultrasonic pachymetry, and topography-derived corneal wavefront. RESULTS: At 7 years compared to preoperative values, mean spherical equivalent refractive error (SEQ) increased by +0.78 diopter (D) (P < .005) and mean simulated topographic keratometry (SimK) and mean maximum keratometry (Kmax) reduced by -0.74 D (P < .0001) and -0.91 D (P < .0001), respectively. Uncorrected distance acuity (UCDA) (P < .0005) and corrected distance acuity (CDVA) (P < .0001) had improved and root mean square (RMS) (P < .0005), coma (P < .0005), and secondary astigmatism (P < .005) lessened. At 7 years compared to 1 year, CDVA improved (P < .05); mean SimK (P < .0005) and mean Kmax (P < .005) reduced by -0.45 D and -0.56 D, respectively; and RMS (P < .0005) and coma (P < .0005) decreased. At 7 years compared to 5 years, CDVA improved (P < .05) and trefoil reduced (P < .05). No treated eyes progressed. In 29 initially untreated fellow eyes mean SimK increased by +0.54 D (P < .02), mean Kmax by +0.87 D (P < .05), and refractive astigmatism increased (P < .0005). CONCLUSIONS: Following corneal cross-linking, improvements in topographic and wavefront parameters evident at 1 year were seen to continue to improve at 5 years and were maintained at 7 years. No treated eyes progressed over the 7-year follow-up period.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fotoquimioterapia / Riboflavina / Córnea / Reactivos de Enlaces Cruzados / Queratocono Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Ophthalmol Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fotoquimioterapia / Riboflavina / Córnea / Reactivos de Enlaces Cruzados / Queratocono Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Ophthalmol Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos