Indian Journal of Ophthalmology (Jan 2014)
Corneal changes following collagen cross linking and simultaneous topography guided photoablation with collagen cross linking for keratoconus
- Prema Padmanabhan,
- Aishwaryah Radhakrishnan,
- Abinaya Priya Venkataraman,
- Nidhi Gupta,
- Bhaskar Srinivasan
Affiliations
- Prema Padmanabhan
- Aishwaryah Radhakrishnan
- Abinaya Priya Venkataraman
- Nidhi Gupta
- Bhaskar Srinivasan
- DOI
- https://doi.org/10.4103/0301-4738.111209
- Journal volume & issue
-
Vol. 62,
no. 2
pp. 229 – 235
Abstract
Purpose: To compare the outcome of Collagen cross-linking (CXL) with that following topography-guided customized ablation treatment (T-CAT) with simultaneous CXL in eyes with progressive keratoconus. Materials and Methods: This was a prospective, non-randomized single centre study of 66 eyes with progressive keratoconus. Of these, 40 eyes underwent CXL and 26 eyes underwent T-CAT + CXL. The refractive, topographic, tomographic and aberrometric changes measured at baseline, 1, 3 and 6 months post-operatively were compared between both groups. Results: After a mean follow-up of 7.7 ± 1.3 months, the mean retinoscopic cylinder decreased by 1.02 ± 3.16 D in the CXL group ( P = 0.1) and 2.87 ± 3.22 D in the T-CAT + CXL group ( P = 0.04). The Best corrected visual acuity increased by 2 lines or more in 10% of eyes in the CXL group and in 23.3% of eyes in the T-CAT + CXL group. The mean steepest-K reduced by 0.40 ± 3.71 D ( P = 0.77) in the CXL group and by 2.91 ± 2.01D ( P = 0.03) in the T-CAT + CXL group. The sag factor and surface asymmetry index showed no significant change in the CXL group but reduced by 3.59 ± 5.94 D ( P = 0.01) and 0.72 ± 1.18 ( P = 0.02) respectively in the T-CAT + CXL group. There was a significant increase in the highest posterior corneal elevation in both groups (9.57 ± 14.93 μ in the CXL group and 7.85 ± 9.25 μ in the T-CAT + CXL group, P ≤ 0.001 for both). There was significantly greater reduction of mean coma ( P < 0.001) and mean higher-order aberrations ( P = 0.01) following T-CAT + CXL compared to CXL. Conclusions: CAT + CXL is an effective approach to confer biomechanical stability and to improve the corneal contour in eyes with keratoconus and results in better refractive, topographic and aberrometric outcomes than CXL alone.
Keywords
- Blindness
- cataract
- eye lens
- risk factors
- treatment of cataract
- Low vision care
- multiple disabilities and visual impairment
- reading performance
- Accommodation
- presbyopia
- supraciliary segment implants
- Amblyopia
- citicoline
- patching
- Corneal endothelium
- human corneal endothelial precursor cells
- in vitro expansion
- sphere forming assay
- thermo-reversible gelation polymer
- transportation
- Endophthalmitis
- explantation
- fungal
- intraocular lens
- postoperative
- recurrent
- Colour perception
- learning disabilities
- school children
- stereo acuity
- testability
- visual acuity
- Contracted socket
- dermis fat graft
- porous orbital implant
- reconstruction
- Glucose
- in vitro anticataract
- lens
- Moringa oliefera
- ′BARC I-125 Ocu-Prosta seeds′
- choroidal melanoma
- ciliary body melanoma
- Episcleral plaque brachytherapy
- retinal angioma
- retinoblastoma
- vasoproliferative tumor
- Congenital glaucoma
- gonioscopy
- Retcam
- Acoustic features
- A-scan
- B-scan
- choroidal mass
- ultrasound biomicroscopy
- Cataract surgery
- education
- informed consent
- multimedia
- rural health
- Lagophthalmos
- silicone sling
- temporalis muscle
- Contrast sensitivity function
- disability
- function peak
- multiple sclerosis
- spatial frequency
- Congenital cataract
- developmental cataract
- outcome
- vision function
- Bacterial
- extracellular enzymes
- fungal
- keratitis
- toxins
- Exotropic Duane retraction syndrome
- periosteal fixation
- strabismus surgery
- vertical rectus transposition
- Descemet′s stripping endothelial keratoplasty
- complications
- donor dislocation
- endothelial cell loss
- graft failure
- management
- Glaucoma
- glaucoma experimental
- parapapillary atrophy
- Juvenile open angle glaucoma
- juvenile glaucoma
- primary trabeculectomy
- trabeculectomy in young
- Collagen cross linking
- keratoconus
- topography guided custom ablation treatment
- topography guided photoablation