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Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi

Year 2022, Volume: 15 Issue: 2, 245 - 252, 31.08.2022
https://doi.org/10.26559/mersinsbd.1076183

Abstract

Amaç: On sekiz yaş altı ve 18 yaş üstünde keratokonus nedeniyle çapraz bağlama tedavisi (ÇB) uygulanan hastalardaki korneal dansitometri değişimlerini karşılaştırmalı olarak değerlendirmektir. Yöntem: Keratokonus tanısıyla ÇB uygulanan 55 hastanın 74 gözü çalışmaya alındı. 18 yaş ve altındaki hastalar grup 1’e dahil edilirken, 18 yaş üstündeki hastalar grup 2’ye dahil edildi. Hastaların ÇB öncesinde ve sonrasında Pentacam Scheimpflug görüntüleme sistemi ile kornea kalınlığı ve korneal dansitometri değerleri ölçülerek kaydedildi. Çapraz bağlama sonrası tüm hastaların kornea kalınlıkları ultrasonik pakimetri ile de ölçüldü ve Scheimpflug sistem ölçümleri ile karşılaştırma yapıldı. Bulgular: Grup 1’de ÇB öncesindeki korneal dansitometri değeri 19.84±2.67 GSU iken, işlem sonrası 21.54±3.32 GSU idi ve aradaki fark istatistiksel olarak anlamlıydı (p=0.048). Benzer şekilde Grup 2’deki dansitometri değeri ÇB öncesinde 18.74±1.56 GSU iken, işlem sonrasında 24.53±10.46 GSU idi ve aradaki fark anlamlıydı (p<0.0001). Grup 1’de Scheimpflug görüntüleme sistemi ile ÇB öncesi ölçülen kornea kalınlığı 473.04±24.23 µ iken, grup 2’de 467.89±29.09 µ idi. Her iki grupta ÇB sonrası kornea kalınlıkları sırasıyla 461.88±27.64 µ ve 446.42±32.76 µ idi ve aradaki fark iki grupta da istatistiksel olarak anlamlıydı (sırasıyla p=0.003, p<0.0001). Sonuç: Keratokonus hastalarında, ÇB sonrasında, çocuk ve erişkinlerde korneal bulanıklık oluşmaktadır. Erişkinlerde çocuklara göre daha fazla bulanıklık olmaktadır. Bulanıklığın takibinde korneal dansitometri objektif veriler sunar. Bulanıklık olan kornealarda kalınlık takibi için ultrasonik pakimetri, Scheimpflug kameraya göre daha doğru ölçümler sunabilir.

References

  • Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998;42(4):297–319.
  • Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratokonus. Am J Ophthalmol. 2003;135(5):620-7.
  • Wollensak G, Spoerl E, Seiler T. Stress-strain measurements of human and porcine corneas after riboflavin–ultraviolet-A-induced cross-linking. J Cataract Refract Surg. 2003;29(9):1780-5.
  • Hersh PS, Stulting RD, Muller D, et al. U.S. Multicenter clinical trial of corneal collagen crosslinking for treatment of corneal ectasia after refractive surgery. Ophthalmology. 2017;124(10):1475–84.
  • Chang CY, Hersh PS. Corneal collagen cross-linking: a review of 1 year outcomes. Eye Contact Lens. 2014;40(6):345-52.
  • Patel S, Winter EJ, McLaren JW, Bourne WM. Objective measurement of backscattered light from the anterior and posterior cornea in vivo. Invest Ophthalmol Vis Sci. 2007;48(1):166–72.
  • Wang J, Simpson TL, Fonn D. Objective measurements of corneal light-backscatter during corneal swelling by optical coherence tomography. Invest Ophthalmol Vis Sci. 2004;45(10):3493–8.
  • Silverman R, Cannata J, Shung KK. 75 MHz ultrasound biomicroscopy of the anterior segment of the eye. Ultrason Imaging. 2006;28(3):179–88.
  • Hillenaar T, Cals RH, Eilers PH, Wubbels RJ, van Cleynenbreugel, H Remeijer L. Normative database for corneal backscatter analysis by in vivo confocal microscopy. Invest Ophthalmol Vis Sci. 2011;52(10):7274–81.
  • Greenstein SA, Fry KL, Bhatt J, et al. Natural history of corneal haze after collagen crosslinking for keratoconus and corneal ectasia: Scheimpflug and biomicroscopic analysis. J Cataract Refract Surg. 2010;36(12):2105–14.
  • Pircher N, Pachala M, Prager F, et al. Changes in straylight and densitometry values after corneal collagen crosslinking. J Cataract Refract Surg. 2015;41(5):1038–43.
  • Akkaya Turhan S, Toker E. Changes in corneal density after accelerated corneal collagen cross-linking with different irradiation intensities and energy exposures: 1-year follow-up. Cornea. 2017;36(11):1331–5.
  • Shen Y, Jian W, Sun L, et al. One-year follow-up of changes in corneal densitometry after accelerated (45 mW/cm2) transepithelial corneal collagen cross-linking for keratoconus: a retrospective study. Cornea. 2016;35(11):1434–40.
  • Kılınç S, Kasım B, Koçluk Y. Çocukluk çağı keratokonus hastalarında çapraz bağlama tedavisi: Uzun dönem sonuçlarımız. Mersin Univ Saglık Bilim Derg. 2018;11(3).
  • Greenstein SA, Shah VP, Fry KL, et al. Corneal thickness changes after corneal collagen crosslinking for keratokonus and corneal ectasia: one-year results. J Cataract Refract Surg. 2011;37(4):691-700.
  • Gutierrez R, Lopez I, Villa-Collar C, et al. Corneal transparency after cross-linking for keratoconus: 1-year follow-up. J Refract Surg. 2012;28(11):781-5.
  • Wollensak G, Wilsch M, Spoerl E, et al. Collagen fiber diameter in the rabbit cornea after collagen crosslinking by riboflavin/UVA. Cornea. 2004;23(5):503-7.
  • Mazzotta C, Caporossi T, Denaro R, et al. Morphological and functional correlations in riboflavin UV A corneal collagen cross-linking for keratoconus. Acta Ophthalmol. 2012;90(3):259–65.
  • Wollensak G, Herbst H. Significance of the lacunar hydration pattern after corneal cross linking. Cornea. 2010;29(8):899–903.
  • Mazzotta C, Hafezi F, Kymionis G, et al. In vivo confocal microscopy after corneal collagen crosslinking. Ocul Surf. 2015;13(4):298–314.
  • Jordan C, Patel D, Abeysekera N, et al. In vivo confocal microscopy analyses of corneal microstructural changes in a prospective study of collagen cross-linking in keratoconus. Ophthalmology. 2014;121(2):469–74
  • Ni Dhubhghaill S, Rozema JJ, Jongenelen S, et al. Normative values for corneal densitometry analysis by Scheimpflug optical assessment. Invest Ophthalmol Vis Sci. 2014;55(1):162–8.
  • Garzón N, Poyales F, Illarramendi I, et al. Corneal densitometry and its correlation with age, pachymetry, corneal curvature, and refraction. Int Ophthalmol. 2016;37(6) 1263–8.
  • Seiler T, Hafezi F. Corneal cross-linking-induced stromal demarcation line. Cornea. 2006;25(9):1057-9.
  • Kim BZ, Jordan CA, McGhee CN, et al. Natural history of corneal haze after corneal collagen crosslinking in keratoconus using Scheimpflug analysis. J Cataract Refract Surg. 2016;42(7):1053-9.
  • Mazzotta C, Traversi C, Baiocchi S, et al. Corneal healing after riboflavin ultraviolet-A collagen cross-linking determined by confocal laser scanning microscopy in vivo: early and late modifications. Am J Ophthalmol. 2008;146(4):527–33.

Scheimpflug Corneal Densitometry analysis after accelerated cross-linking in pediatric and adult Keratoconus patients

Year 2022, Volume: 15 Issue: 2, 245 - 252, 31.08.2022
https://doi.org/10.26559/mersinsbd.1076183

Abstract

Purpose: To compare the corneal densitometry in patients under and above 18 years of age who have had corneal collagen cross-linking (CXL) treatment for keratoconus. Method: Seventy-four eyes of 55 patients who have had corneal CXL with a diagnosis of keratoconus were included. Patients under 18 years were included in group 1, while patients over 18 years of age were in group 2. Corneal thickness and corneal densitometry were measured and recorded with Pentacam Scheimpflug imaging system, before and after corneal CXL. Corneal thicknesses of patients were also measured by ultrasonic pachymetry and compared with Scheimpflug system measurements, after CXL. Results: Corneal densitometry value before CXL was 19.84±2.67 GSU in group 1, while 21.54±3.32 GSU after the procedure and the difference was statistically significant (p=0.048). Similarly, corneal densitometry value in group 2 was 18.74±1.56 GSU before CXL, while 24.53±10.46 GSU after the procedure and the difference was significant (p<0.0001). Corneal thickness measured before CXL with the Scheimpflug imaging system was 473.04±24.23 µ in group 1 and 467.89±29.09 µ in group 2. Corneal thickness after CXL were 461.88±27.64 µ and 446.42±32.76 µ in group 1 and group 2, respectively, and the difference was statistically significant (p=0.003, p<0.0001, respectively). Conclusion: Corneal haze occures in children and adults after CXL in keratoconus. More haze occurs in adults than children. Corneal densitometry provides objective data in haze. Ultrasonic pachymetry can provide more accurate measurements than Scheimpflug camera in thickness measurements of corneas with haze.

References

  • Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998;42(4):297–319.
  • Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratokonus. Am J Ophthalmol. 2003;135(5):620-7.
  • Wollensak G, Spoerl E, Seiler T. Stress-strain measurements of human and porcine corneas after riboflavin–ultraviolet-A-induced cross-linking. J Cataract Refract Surg. 2003;29(9):1780-5.
  • Hersh PS, Stulting RD, Muller D, et al. U.S. Multicenter clinical trial of corneal collagen crosslinking for treatment of corneal ectasia after refractive surgery. Ophthalmology. 2017;124(10):1475–84.
  • Chang CY, Hersh PS. Corneal collagen cross-linking: a review of 1 year outcomes. Eye Contact Lens. 2014;40(6):345-52.
  • Patel S, Winter EJ, McLaren JW, Bourne WM. Objective measurement of backscattered light from the anterior and posterior cornea in vivo. Invest Ophthalmol Vis Sci. 2007;48(1):166–72.
  • Wang J, Simpson TL, Fonn D. Objective measurements of corneal light-backscatter during corneal swelling by optical coherence tomography. Invest Ophthalmol Vis Sci. 2004;45(10):3493–8.
  • Silverman R, Cannata J, Shung KK. 75 MHz ultrasound biomicroscopy of the anterior segment of the eye. Ultrason Imaging. 2006;28(3):179–88.
  • Hillenaar T, Cals RH, Eilers PH, Wubbels RJ, van Cleynenbreugel, H Remeijer L. Normative database for corneal backscatter analysis by in vivo confocal microscopy. Invest Ophthalmol Vis Sci. 2011;52(10):7274–81.
  • Greenstein SA, Fry KL, Bhatt J, et al. Natural history of corneal haze after collagen crosslinking for keratoconus and corneal ectasia: Scheimpflug and biomicroscopic analysis. J Cataract Refract Surg. 2010;36(12):2105–14.
  • Pircher N, Pachala M, Prager F, et al. Changes in straylight and densitometry values after corneal collagen crosslinking. J Cataract Refract Surg. 2015;41(5):1038–43.
  • Akkaya Turhan S, Toker E. Changes in corneal density after accelerated corneal collagen cross-linking with different irradiation intensities and energy exposures: 1-year follow-up. Cornea. 2017;36(11):1331–5.
  • Shen Y, Jian W, Sun L, et al. One-year follow-up of changes in corneal densitometry after accelerated (45 mW/cm2) transepithelial corneal collagen cross-linking for keratoconus: a retrospective study. Cornea. 2016;35(11):1434–40.
  • Kılınç S, Kasım B, Koçluk Y. Çocukluk çağı keratokonus hastalarında çapraz bağlama tedavisi: Uzun dönem sonuçlarımız. Mersin Univ Saglık Bilim Derg. 2018;11(3).
  • Greenstein SA, Shah VP, Fry KL, et al. Corneal thickness changes after corneal collagen crosslinking for keratokonus and corneal ectasia: one-year results. J Cataract Refract Surg. 2011;37(4):691-700.
  • Gutierrez R, Lopez I, Villa-Collar C, et al. Corneal transparency after cross-linking for keratoconus: 1-year follow-up. J Refract Surg. 2012;28(11):781-5.
  • Wollensak G, Wilsch M, Spoerl E, et al. Collagen fiber diameter in the rabbit cornea after collagen crosslinking by riboflavin/UVA. Cornea. 2004;23(5):503-7.
  • Mazzotta C, Caporossi T, Denaro R, et al. Morphological and functional correlations in riboflavin UV A corneal collagen cross-linking for keratoconus. Acta Ophthalmol. 2012;90(3):259–65.
  • Wollensak G, Herbst H. Significance of the lacunar hydration pattern after corneal cross linking. Cornea. 2010;29(8):899–903.
  • Mazzotta C, Hafezi F, Kymionis G, et al. In vivo confocal microscopy after corneal collagen crosslinking. Ocul Surf. 2015;13(4):298–314.
  • Jordan C, Patel D, Abeysekera N, et al. In vivo confocal microscopy analyses of corneal microstructural changes in a prospective study of collagen cross-linking in keratoconus. Ophthalmology. 2014;121(2):469–74
  • Ni Dhubhghaill S, Rozema JJ, Jongenelen S, et al. Normative values for corneal densitometry analysis by Scheimpflug optical assessment. Invest Ophthalmol Vis Sci. 2014;55(1):162–8.
  • Garzón N, Poyales F, Illarramendi I, et al. Corneal densitometry and its correlation with age, pachymetry, corneal curvature, and refraction. Int Ophthalmol. 2016;37(6) 1263–8.
  • Seiler T, Hafezi F. Corneal cross-linking-induced stromal demarcation line. Cornea. 2006;25(9):1057-9.
  • Kim BZ, Jordan CA, McGhee CN, et al. Natural history of corneal haze after corneal collagen crosslinking in keratoconus using Scheimpflug analysis. J Cataract Refract Surg. 2016;42(7):1053-9.
  • Mazzotta C, Traversi C, Baiocchi S, et al. Corneal healing after riboflavin ultraviolet-A collagen cross-linking determined by confocal laser scanning microscopy in vivo: early and late modifications. Am J Ophthalmol. 2008;146(4):527–33.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Özer Dursun 0000-0003-4216-0814

Mustafa Vatansever 0000-0003-2020-4417

Levent Göbel This is me 0000-0002-5527-8240

Ömer Özer 0000-0003-0329-0931

Erdem Dinç 0000-0003-3462-1502

Gülhan Temel 0000-0002-2835-6979

Publication Date August 31, 2022
Submission Date February 19, 2022
Acceptance Date May 24, 2022
Published in Issue Year 2022 Volume: 15 Issue: 2

Cite

APA Dursun, Ö., Vatansever, M., Göbel, L., Özer, Ö., et al. (2022). Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 15(2), 245-252. https://doi.org/10.26559/mersinsbd.1076183
AMA Dursun Ö, Vatansever M, Göbel L, Özer Ö, Dinç E, Temel G. Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi. Mersin Univ Saglık Bilim derg. August 2022;15(2):245-252. doi:10.26559/mersinsbd.1076183
Chicago Dursun, Özer, Mustafa Vatansever, Levent Göbel, Ömer Özer, Erdem Dinç, and Gülhan Temel. “Çocuk Ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama Tedavisi Sonrası Scheimpflug Kornea Dansitometri Analizi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 15, no. 2 (August 2022): 245-52. https://doi.org/10.26559/mersinsbd.1076183.
EndNote Dursun Ö, Vatansever M, Göbel L, Özer Ö, Dinç E, Temel G (August 1, 2022) Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi. Mersin Üniversitesi Sağlık Bilimleri Dergisi 15 2 245–252.
IEEE Ö. Dursun, M. Vatansever, L. Göbel, Ö. Özer, E. Dinç, and G. Temel, “Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi”, Mersin Univ Saglık Bilim derg, vol. 15, no. 2, pp. 245–252, 2022, doi: 10.26559/mersinsbd.1076183.
ISNAD Dursun, Özer et al. “Çocuk Ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama Tedavisi Sonrası Scheimpflug Kornea Dansitometri Analizi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 15/2 (August 2022), 245-252. https://doi.org/10.26559/mersinsbd.1076183.
JAMA Dursun Ö, Vatansever M, Göbel L, Özer Ö, Dinç E, Temel G. Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi. Mersin Univ Saglık Bilim derg. 2022;15:245–252.
MLA Dursun, Özer et al. “Çocuk Ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama Tedavisi Sonrası Scheimpflug Kornea Dansitometri Analizi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi, vol. 15, no. 2, 2022, pp. 245-52, doi:10.26559/mersinsbd.1076183.
Vancouver Dursun Ö, Vatansever M, Göbel L, Özer Ö, Dinç E, Temel G. Çocuk ve erişkin Keratokonus hastalarında hızlandırılmış çapraz bağlama tedavisi sonrası Scheimpflug Kornea Dansitometri analizi. Mersin Univ Saglık Bilim derg. 2022;15(2):245-52.

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