1
|
Sun L, Zhang X, Ding L, Zhao J, Shen Y, Tian M, Jian W, Zhou X. Long-term changes in crystalline lens transparency after accelerated transepithelial corneal cross-linking in patients with keratoconus. Eur J Ophthalmol 2023; 33:1850-1859. [PMID: 37077155 DOI: 10.1177/11206721231170036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE To investigate the long-term clinical outcomes and changes in crystalline lens transparency after accelerated (45 mW/cm2) transepithelial corneal cross-linking (ATE-CXL) using the Pentacam imaging system in patients with progressive keratoconus. METHODS The study prospectively included 44 keratoconus eyes of 40 patients (mean age: 24.39 ± 5.61 years) who underwent ATE-CXL. The examinations, including assessment of uncorrected distance visual acuity, corrected distance visual acuity, corneal topography, and corneal endothelial cell density count, were conducted preoperatively and 1 month, 3 months, 6 months, 1 year, and 5 years postoperatively. Measurement of crystalline lens density using Pentacam images was also performed pre- and postoperatively. RESULTS All surgeries were uneventful with no postoperative complications. All keratometry values and corneal thickness remained stable during the 5-year follow-up period (all p > 0.05). There were no significant differences in corneal endothelial cell density count, visual acuity, and anterior average lens density in the 0.5-, 1.0-, and 1.5-mm depth zones during the 5-year follow-up period compared with the preoperative values (all p > 0.05). CONCLUSION The results of this study suggest that ATE-CXL at 45 mW/cm2 is safe and effective for the treatment of progressive keratoconus in terms of both crystalline lens density and endothelial cell density.
Collapse
Affiliation(s)
- Ling Sun
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xiaoyu Zhang
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Lan Ding
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jing Zhao
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yang Shen
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Mi Tian
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Weijun Jian
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Key NHC Key Laboratory of Myopia (Fudan University); Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| |
Collapse
|
2
|
Dettoraki M, Droutsas K, Lazaridis A, Moschos MM. Evaluation of macular function and morphology following accelerated collagen cross-linking in progressive keratoconus. Eur J Ophthalmol 2022; 32:2547-2553. [PMID: 35450449 DOI: 10.1177/11206721221094880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess any changes in macular function and morphology in patients with progressive keratoconus undergoing accelerated corneal cross-linking (CXL). METHODS This prospective case series included 9 eyes of 8 patients with progressive keratoconus undergoing CXL using a high intensity accelerated protocol (9 mW/cm2 for 14 min) with a total surface dose of 7.5 J/cm2. Visual acuity assessment, slit lamp biomicroscopy, dilated fundoscopy, corneal tomography, multifocal electroretinography (mfERG) and spectral domain optical coherence tomography scan were performed at baseline, 2 weeks and 6 weeks postoperatively. RESULTS Uncorrected and corrected distance visual acuity did not change significantly at 2 weeks and 6 weeks following accelerated CXL compared to baseline. Retinal response density (RRD) of mfERG significantly decreased at 2 weeks postoperatively compared to baseline (p = 0.008) but did not differ from the baseline value at 6 weeks postoperatively in the fovea (ring 1) (p = 0.95). Similarly, P1 latency significantly decreased at 2 weeks (p = 0.04) but did not change at 6 weeks (p = 1.00) postoperatively compared to baseline in the fovea. No changes in RRD or P1 latency were observed in the retinal rings surrounding the fovea (rings 2 to 5). Central foveal thickness did not change at 2 weeks and 6 weeks postoperatively compared to baseline (p = 0.53 and p = 0.93, respectively). CONCLUSIONS A short-term reversible decrease in macular electrical activity without any structural changes seems to occur after accelerated CXL in patients with progressive keratoconus. The return of macular response to the preoperative values shows the safety of the CXL protocol.
Collapse
Affiliation(s)
- M Dettoraki
- First Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
| | - K Droutsas
- First Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece.,Department of Ophthalmology, 98594Philipps University of Marburg, Marburg, Germany
| | - A Lazaridis
- Department of Ophthalmology, 98594Philipps University of Marburg, Marburg, Germany
| | - M M Moschos
- First Department of Ophthalmology, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
3
|
Nasrollahi K, Razmjoo F, Naderan M, Peyman A. Corneal cross-linking for keratoconus: Evaluation of the retina and choroid. Eur J Ophthalmol 2021; 32:1491-1495. [PMID: 34053332 DOI: 10.1177/11206721211021300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate the possible structural changes of the central choroid and retina after collagen cross-linking (CXL) in patients with progressive keratoconus (KCN). METHODS Twenty-five eyes of 25 patients were included in this study. Patients underwent enhanced depth imaging optical coherence tomography (EDI-OCT) before and 1 month after CXL. The values for central macular thickness (CMT), subfoveal choroidal thickness (CHT), and choroidal volume (CHV) were evaluated. RESULTS CMT before and after CXL was 263.24 ± 16.25 μm and 263.20 ± 16.51 μm, respectively (p = 0.98). CHT was 362.08 ± 36.80 μm and 367.84 ± 33.67 μm before and after CXL, respectively (p = 0.26). CHV was 8.74 ± 0.33 mm3 and 8.68 ± 0.36 mm3 before and after CXL, respectively (p = 0.11). There was no significant difference in the corrected distance visual acuity before and after CXL (0.06 ± 0.05 and 0.05 ± 0.05 logMAR, respectively, p = 0.65). CONCLUSION Central retinal and choroidal thicknesses are not changed after corneal cross- linking.
Collapse
Affiliation(s)
- Kobra Nasrollahi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Razmjoo
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Naderan
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Peyman
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
4
|
The evaluation of corneal topographic parameters with corneal and lens densitometers in pediatric keratoconus. Int Ophthalmol 2020; 41:541-548. [PMID: 33048254 DOI: 10.1007/s10792-020-01605-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to compare corneal and lens densitometric measurements and corneal topographic parameters of pediatric keratoconus patients and healthy individuals. METHODS The data of the Pentacam® HR device and the database of our hospital between 2017 and 2019 were analyzed retrospectively. A total of 80 eyes of 47 keratoconus children (one eye of 14 children and two eyes of 33 children) in the Group KC (n = 80); and 74 eyes of 37 children were assessed in healthy children, Group HC (n = 74). The corneal density was measured manually in full-thickness cornea with a diameter of 2 mm in the corneal apex. The lens density (LD) was measured manually in the pupillary area with a diameter of 2 mm throughout the whole central lens thickness in 3D mode. RESULTS The corneal density values were significantly higher in Group KC (12.72 ± 1.68, 1.00 ± 0.34, 16.36 ± 2.32, respectively) compared to Group HC (9.81 ± 1.02, 0.61 ± 0.28, 12.42 ± 1.44, respectively) (p < 0.001). LD-mean and LD-sd measurements were lower in Group KC (7.55 ± 0.48, 0.61 ± 0.49, respectively) compared to Group HC (7.75 ± 0.39, 0.81 ± 0.49, respectively) (p = 0.004, p = 0.014, respectively). CONCLUSION It was found that corneal density increased and lens density decreased in pediatric keratoconus patients. These results showed that there may be factors that prevent or delay lens changes in isolated pediatric keratoconus patients.
Collapse
|
6
|
Mirzaei M, Bagheri M, Taheri A. Influence of standard corneal cross-linking in keratoconus patients on macular profile. J Curr Ophthalmol 2018; 30:330-336. [PMID: 30555966 PMCID: PMC6277222 DOI: 10.1016/j.joco.2018.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/28/2018] [Accepted: 06/09/2018] [Indexed: 12/03/2022] Open
Abstract
Purpose To determine the effect of corneal cross-linking (CXL) on retinal structure and function. Methods The current study was conducted on 42 eyes of 21 patients with keratoconus (KCN) who were candidates for CXL due to disease progression. The Optovue optical coherence tomography (OCT) (Optovue Inc., Fremont, USA) from macula and multifocal electroretinography (mERG) were performed on all patients prior to surgery and at 1- and 6- month follow-up. Structural and functional parameters of macula including retinal thickness in OCT, and amplitude and latency of electroretinogram were compared between eyes that underwent surgery and control fellow eyes during the study period. Results A statistically significant increase in central foveal, foveal, parafoveal, and perifoveal thickness was observed at 1-month follow-up. The changes were non-significant at 6 months. Although a statistically significant reduction in amplitude and increase in latency in both rings 2 and 3 were observed at 1 month in mERG, only amplitude changes in ring 2 remained significant at 6 months. Conclusion Transient anatomical and functional alterations following CXL were observed in the current study.
Collapse
Affiliation(s)
- Mohammad Mirzaei
- Department of Ophthalmology, Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masood Bagheri
- Department of Ophthalmology, Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Taheri
- Department of Ophthalmology, Nikookari Eye Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|