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İLERLEYİCİ KERATOKONUSTA HIZLANDIRILMIŞ ( 9 MW/CM²) KOLLAJEN ÇAPRAZ BAĞLAMA TEDAVİSİ: 12 AYLIK TAKİP SONUÇLARI

Year 2018, Volume: 1 Issue: 1, 15 - 19, 13.08.2018

Abstract

Giriş: Bu çalışmada amacımız ilerleyici keratokonuslu olgularda, hızlandırılmış kollajen çapraz bağlanma (KÇB)
tedavisinin görme keskinliği ve topografik parametreler üzerindeki sonuçlarını incelemektir.
Yöntem: İlerleyici keratokonus tanılı 29 hastanın 29 gözüne epiteli kazındıktan ve riboflavin damlatıldıktan sonra
hızlandırılış KÇB (10 dakika boyunca 9 mW/cm² Ultraviyole A (UV-A) ) tedavisi uygulanmıştır. Ameliyat öncesi ve ameliyat sonrası 12. ayın sonunda Sirius cihazı kullanılarak elde edilen kornea topografisi değerleri istatistiksel olarak
karşılaştırıldı.
Bulgular: Ameliyat sonrası 12. ayda düzeltilmemiş görme keskinliği (DGK) ile en iyi düzeltilmiş görme keskinliği
(EİDGK) tüm hastalarda ameliyat öncesi değerlere göre istatistiksel olarak anlamlı derecede iyileşme gösterdi (hepsi
için p< 0,05). Düz keratometri (K1) değeri anlamlı olarak değişmez iken, dik keratometri (K2), ortalama keratometri
(Kort) ve maksimum keratometri (Kmax) değerleri istatistiksel olarak anlamlı derecede düşük bulundu (hepsi için p<
0,05). Korelasyon analizinde ameliyat öncesi ve sonrası 12.ayda Kmax değişim değeri ile ameliyat öncesi DGK, EİDGK
ve Kmax değerleri arasında pozitif korelasyon olduğu görüldü (r = 0,409, p = 0,027; r = 0,744, p <0,001; r = 0,955, p
<0,001).
Tartışma: İlerleyici keratokonus hastalarında 10 dakikalık 9 mW/cm² hızlandırılmış KÇB tedavisi 1 yıllık takip sonunda görme keskinliğinde artış ve keratometrik değerlerde iyileşme sağlayarak hastalığın ilerlemesini durdurmada
etkili bulunmuştur.

References

  • 1. Galvis V, Sherwin T, Tello A, Merayo J, Barrera R, Acera A. Keratoconus: an inflammatory disorder? Eye. Jul 2015;29(7):843-859.
  • 2. Wheeler J, Hauser MA, Afshari NA, Allingham RR, Liu Y. The Genetics of Keratoconus: A Review. Reproductive system & sexual disorders : current research. Jun 3 2012(Suppl 6).
  • 3. Ruckhofer J, Stoiber J, Alzner E, Grabner G. [Intrastromal corneal ring segments (ICRS, KeraVision Ring, Intacs): clinical outcome after 2 years]. Klinische Monatsblatter fur Augenheilkunde. Mar 2000;216(3):133-142.
  • 4. Twa MD, Karpecki PM, King BJ, Linn SH, Durrie DS, Schanzlin DJ. One-year results from the phase III investigation of the KeraVision Intacs. Journal of the American Optometric Association. Aug 1999;70(8):515-524.
  • 5. Grabner G, Ruckhofer J, Tratter C, Alzner E. [The intrastromal corneal ring (KeraVision Ring, ICR, ICRS). A modern method for correcting minor myopia]. Wiener medizinische Wochenschrift. 1997;147(12-13):309-321.
  • 6. Wollensak G. Crosslinking treatment of progressive keratoconus: new hope. Current opinion in ophthalmology. Aug 2006;17(4):356-360.
  • 7. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. American journal of ophthalmology. May 2003;135(5):620-627.
  • 8. Hammer A, Richoz O, Arba Mosquera S, Tabibian D, Hoogewoud F, Hafezi F. Corneal biomechanical properties at different corneal cross-linking (CXL) irradiances. Investigative ophthalmology & visual science. May 2 2014;55(5):2881-2884.
  • 9. Strmenova E, Vlkova E, Michalcova L, et al. [The effectiveness of corneal cross-linking in stopping the progression of keratoconus]. Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti. Dec 2014;70(6):218-222.
  • 10. Kymionis GD, Grentzelos MA, Liakopoulos DA, et al. Long-term follow-up of corneal collagen cross-linking for keratoconus--the Cretan study. Cornea. Oct 2014;33(10):1071-1079.
  • 11. Brittingham S, Tappeiner C, Frueh BE. Corneal cross-linking in keratoconus using the standard and rapid treatment protocol: differences in demarcation line and 12-month outcomes. Investigative ophthalmology & visual science. Dec 2 2014;55(12):8371-8376.
  • 12. Zotta PG, Moschou KA, Diakonis VF, et al. Corneal collagen cross-linking for progressive keratoconus in pediatric patients: a feasibility study. Journal of refractive surgery. Nov 2012;28(11):793-799.
  • 13. Tomita M, Mita M, Huseynova T. Accelerated versus conventional corneal collagen crosslinking. Journal of cataract and refractive surgery. Jun 2014;40(6):1013-1020.
  • 14. Cinar Y, Cingu AK, Turkcu FM, et al. Accelerated corneal collagen cross-linking for progressive keratoconus. Cutaneous and ocular toxicology. Jun 2014;33(2):168-171.
  • 15. Ozgurhan EB, Kara N, Cankaya KI, Kurt T, Demirok A. Accelerated corneal cross-linking in pediatric patients with keratoconus: 24-month outcomes. Journal of refractive surgery. Dec 2014;30(12):843-849.
  • 16. Alnawaiseh M, Rosentreter A, Bohm MR, Eveslage M, Eter N, Zumhagen L. Accelerated (18 mW/cm(2)) Corneal Collagen Cross-Linking for Progressive Keratoconus. Cornea. Nov 2015;34(11):1427-1431.
  • 17. Hashemi H, Miraftab M, Seyedian MA, et al. Long-term Results of an Accelerated Corneal Cross-linking Protocol (18 mW/cm2) for the Treatment of Progressive Keratoconus. American journal of ophthalmology. Dec 2015;160(6):1164-1170 e1161.
  • 18. Waszczykowska A, Jurowski P. Two-year accelerated corneal cross-linking outcome in patients with progressive keratoconus. BioMed research international. 2015;2015:325157.
  • 19. Choi M, Kim J, Kim EK, Seo KY, Kim TI. Comparison of the Conventional Dresden Protocol and Accelerated Protocol With Higher Ultraviolet Intensity in Corneal Collagen Cross-Linking for Keratoconus. Cornea. May 2017;36(5):523-529.
  • 20. Elbaz U, Shen C, Lichtinger A, et al. Accelerated (9-mW/cm2) corneal collagen crosslinking for keratoconus-A 1-year follow-up. Cornea. Aug 2014;33(8):769-773.
  • 21. Epstein RL, Chiu YL, Epstein GL. Pentacam HR criteria for curvature change in keratoconus and postoperative LASIK ectasia. Journal of refractive surgery. Dec 2012;28(12):890-894.

ACCELERATED (9 MW/CM2) CORNEAL COLLAGEN CROSSLİNKİNG FOR PROGRESSİVE KERATOCONUS-A 1-YEAR FOLLOW-UP

Year 2018, Volume: 1 Issue: 1, 15 - 19, 13.08.2018

Abstract

Introduction: In this study, we aimed to investigate the effects of accelerated collagen cross-linking treatment on
visual acuity and topographic parameters in progressive keratoconus cases.
Method: Twenty-nine eyes of 29 patients with progressive keratoconus were treated with accelarated epi-off CXL
(9 mW / cm² Ultraviolet (UV-A) treatment for 10 minutes). After one-year follow up data obtained by Sirius topography
system were compared with the baseline topographic parameters.
Results: Uncorrected visual acuity (BCVA) and best corrected visual acuity (BCVA) improved statistically significantly in all patients at 12 months postoperatively (p<0,05 for all). Steep keratometry (K2), mean keratometry (Kort),
and maximum keratometry (Kmax) values were found to be statistically significantly lower (p <0.05 for all), however
Flat keratometry (K1) was not differed significantly. Correlation analysis revealed a positive correlation between preoperative and postoperative Kmax change values, preoperative BCVA, BCVA and Kmax values (r = 0,409, p = 0,027, r =
0,744, p <0,001, r = 0,955, p <0,001 ).
Discussion: The 10 minute 9-mW / cm² accelerated collagen cross-linking treatment in progressive keratoconus
patients was found to be effective in increasing visual acuity and improving keratometric values and prevent disease
progression after 1 year of follow-up. 

References

  • 1. Galvis V, Sherwin T, Tello A, Merayo J, Barrera R, Acera A. Keratoconus: an inflammatory disorder? Eye. Jul 2015;29(7):843-859.
  • 2. Wheeler J, Hauser MA, Afshari NA, Allingham RR, Liu Y. The Genetics of Keratoconus: A Review. Reproductive system & sexual disorders : current research. Jun 3 2012(Suppl 6).
  • 3. Ruckhofer J, Stoiber J, Alzner E, Grabner G. [Intrastromal corneal ring segments (ICRS, KeraVision Ring, Intacs): clinical outcome after 2 years]. Klinische Monatsblatter fur Augenheilkunde. Mar 2000;216(3):133-142.
  • 4. Twa MD, Karpecki PM, King BJ, Linn SH, Durrie DS, Schanzlin DJ. One-year results from the phase III investigation of the KeraVision Intacs. Journal of the American Optometric Association. Aug 1999;70(8):515-524.
  • 5. Grabner G, Ruckhofer J, Tratter C, Alzner E. [The intrastromal corneal ring (KeraVision Ring, ICR, ICRS). A modern method for correcting minor myopia]. Wiener medizinische Wochenschrift. 1997;147(12-13):309-321.
  • 6. Wollensak G. Crosslinking treatment of progressive keratoconus: new hope. Current opinion in ophthalmology. Aug 2006;17(4):356-360.
  • 7. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. American journal of ophthalmology. May 2003;135(5):620-627.
  • 8. Hammer A, Richoz O, Arba Mosquera S, Tabibian D, Hoogewoud F, Hafezi F. Corneal biomechanical properties at different corneal cross-linking (CXL) irradiances. Investigative ophthalmology & visual science. May 2 2014;55(5):2881-2884.
  • 9. Strmenova E, Vlkova E, Michalcova L, et al. [The effectiveness of corneal cross-linking in stopping the progression of keratoconus]. Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti. Dec 2014;70(6):218-222.
  • 10. Kymionis GD, Grentzelos MA, Liakopoulos DA, et al. Long-term follow-up of corneal collagen cross-linking for keratoconus--the Cretan study. Cornea. Oct 2014;33(10):1071-1079.
  • 11. Brittingham S, Tappeiner C, Frueh BE. Corneal cross-linking in keratoconus using the standard and rapid treatment protocol: differences in demarcation line and 12-month outcomes. Investigative ophthalmology & visual science. Dec 2 2014;55(12):8371-8376.
  • 12. Zotta PG, Moschou KA, Diakonis VF, et al. Corneal collagen cross-linking for progressive keratoconus in pediatric patients: a feasibility study. Journal of refractive surgery. Nov 2012;28(11):793-799.
  • 13. Tomita M, Mita M, Huseynova T. Accelerated versus conventional corneal collagen crosslinking. Journal of cataract and refractive surgery. Jun 2014;40(6):1013-1020.
  • 14. Cinar Y, Cingu AK, Turkcu FM, et al. Accelerated corneal collagen cross-linking for progressive keratoconus. Cutaneous and ocular toxicology. Jun 2014;33(2):168-171.
  • 15. Ozgurhan EB, Kara N, Cankaya KI, Kurt T, Demirok A. Accelerated corneal cross-linking in pediatric patients with keratoconus: 24-month outcomes. Journal of refractive surgery. Dec 2014;30(12):843-849.
  • 16. Alnawaiseh M, Rosentreter A, Bohm MR, Eveslage M, Eter N, Zumhagen L. Accelerated (18 mW/cm(2)) Corneal Collagen Cross-Linking for Progressive Keratoconus. Cornea. Nov 2015;34(11):1427-1431.
  • 17. Hashemi H, Miraftab M, Seyedian MA, et al. Long-term Results of an Accelerated Corneal Cross-linking Protocol (18 mW/cm2) for the Treatment of Progressive Keratoconus. American journal of ophthalmology. Dec 2015;160(6):1164-1170 e1161.
  • 18. Waszczykowska A, Jurowski P. Two-year accelerated corneal cross-linking outcome in patients with progressive keratoconus. BioMed research international. 2015;2015:325157.
  • 19. Choi M, Kim J, Kim EK, Seo KY, Kim TI. Comparison of the Conventional Dresden Protocol and Accelerated Protocol With Higher Ultraviolet Intensity in Corneal Collagen Cross-Linking for Keratoconus. Cornea. May 2017;36(5):523-529.
  • 20. Elbaz U, Shen C, Lichtinger A, et al. Accelerated (9-mW/cm2) corneal collagen crosslinking for keratoconus-A 1-year follow-up. Cornea. Aug 2014;33(8):769-773.
  • 21. Epstein RL, Chiu YL, Epstein GL. Pentacam HR criteria for curvature change in keratoconus and postoperative LASIK ectasia. Journal of refractive surgery. Dec 2012;28(12):890-894.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Mustafa Eliaçık

Ahmet Kırgız This is me

Publication Date August 13, 2018
Submission Date July 7, 2018
Published in Issue Year 2018 Volume: 1 Issue: 1

Cite

Vancouver Eliaçık M, Kırgız A. İLERLEYİCİ KERATOKONUSTA HIZLANDIRILMIŞ ( 9 MW/CM²) KOLLAJEN ÇAPRAZ BAĞLAMA TEDAVİSİ: 12 AYLIK TAKİP SONUÇLARI. MRR. 2018;1(1):15-9.