Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results

Ana Maria Cunha,1 Tiago Sardinha,2 Luís Torrão,1 Raúl Moreira,1 Fernando Falcão-Reis,1,3 João Pinheiro-Costa1,4 1Department of Ophthalmology, Centro Hospitalar De São João, Porto, Portugal; 2Faculty of Medicine, University...

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Autores principales:	Cunha AM, Sardinha T, Torrão L, Moreira R, Falcão-Reis F, Pinheiro-Costa J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	cornea keratoconus disease progression trans-epithelial crosslinking Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/07237454a397476a8a3903e3875319d0
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spelling	oai:doaj.org-article:07237454a397476a8a3903e3875319d02021-12-02T10:04:30ZTransepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results1177-5483https://doaj.org/article/07237454a397476a8a3903e3875319d02020-08-01T00:00:00Zhttps://www.dovepress.com/transepithelial-accelerated-corneal-collagen-cross-linking-two-year-re-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ana Maria Cunha,1 Tiago Sardinha,2 Luís Torrão,1 Raúl Moreira,1 Fernando Falcão-Reis,1,3 João Pinheiro-Costa1,4 1Department of Ophthalmology, Centro Hospitalar De São João, Porto, Portugal; 2Faculty of Medicine, University of Porto, Porto, Portugal; 3Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; 4Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, PortugalCorrespondence: Ana Maria CunhaDepartment of OphthalmologyJoão, Centro Hospitalar De São, Avenida Prof. Hernâni Monteiro, 4202 – 451, Porto, PortugalTel +351 225512100Fax +351 225513669Email ana.cunha.18@gmail.comPurpose: To report 2-year outcomes of trans-epithelial accelerated corneal collagen crosslinking (TE-ACXL) procedure in the treatment of progressive keratoconus patients.Patients and Methods: Twenty-four eyes from 24 patients who underwent TE-ACXL (6mW/cm2 for 15 minutes) were included in this retrospective interventional study. Best-corrected visual acuity (BCVA), keratometry values, thinnest corneal thickness (PachyMin) and topometric indexes were analysed preoperatively and at 6-month, 12-month, 18-month and 24-month postoperative. Progression was assessed by increase ≥ 1.00D in maximum keratometry (Kmax); increase ≥ 1.00D in corneal astigmatism; decrease ≥ 2% in PachyMin; increase ≥ 0.42 in D-index.Results: There were no complications during or after TE-ACXL. No significant differences (Δ) were observed between baseline and 12-month or 24-month postoperative: ∆BCVA (− 0.08 ± 0.25, p=0.190; − 0.04 ± 0.17, p=0.588), ∆Kmax (− 0.08 ± 1.32, p=0.792; − 1.04 ± 1.89, p=0.135), ∆Astigmatism (− 0.15 ± 0.89, p=0.485; − 0.24 ± 1.38, p=0.609), ∆PachyMin (− 0.56 ± 15.70, p=0.882; 0.56 ± 18.74, p=0.931), ∆Index Surface Variation (∆ISV) (− 2.11 ± 10.27, p=0.395; − 4.67 ± 17.32, p=0.442), ∆Index Vertical Asymmetry (∆IVA) (− 0.05 ± 0.17, p=0.208; − 0.08 ± 0.26, p=0.397), ∆Index Height Decentration (∆IHD) (0.00 ± 0.02, p=0.368; − 0.01 ± 0.04, p=0.484), ∆KI (0.00 ± 0.05, p=0.851; 0.01 ± 0.06, p=0.877) and ∆D-index (0.15 ± 1.14, p=0.572; 0.06 ± 1.36, p=0.892). Eleven to 33% of patients had disease progression at 24-month postoperative according to the parameters used to determine progression.Conclusion: Although some patients maintain disease progression, TE-ACXL seems to be a safe and effective treatment for keratoconus over the 2-year follow-up period. Studies with longer follow-up periods and larger patient cohorts are recommended.Keywords: cornea, keratoconus, disease progression, transepithelial, cross-linkingCunha AMSardinha TTorrão LMoreira RFalcão-Reis FPinheiro-Costa JDove Medical Pressarticlecorneakeratoconusdisease progressiontrans-epithelialcrosslinkingOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2329-2337 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	cornea keratoconus disease progression trans-epithelial crosslinking Ophthalmology RE1-994
spellingShingle	cornea keratoconus disease progression trans-epithelial crosslinking Ophthalmology RE1-994 Cunha AM Sardinha T Torrão L Moreira R Falcão-Reis F Pinheiro-Costa J Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
description	Ana Maria Cunha,1 Tiago Sardinha,2 Luís Torrão,1 Raúl Moreira,1 Fernando Falcão-Reis,1,3 João Pinheiro-Costa1,4 1Department of Ophthalmology, Centro Hospitalar De São João, Porto, Portugal; 2Faculty of Medicine, University of Porto, Porto, Portugal; 3Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal; 4Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, PortugalCorrespondence: Ana Maria CunhaDepartment of OphthalmologyJoão, Centro Hospitalar De São, Avenida Prof. Hernâni Monteiro, 4202 – 451, Porto, PortugalTel +351 225512100Fax +351 225513669Email ana.cunha.18@gmail.comPurpose: To report 2-year outcomes of trans-epithelial accelerated corneal collagen crosslinking (TE-ACXL) procedure in the treatment of progressive keratoconus patients.Patients and Methods: Twenty-four eyes from 24 patients who underwent TE-ACXL (6mW/cm2 for 15 minutes) were included in this retrospective interventional study. Best-corrected visual acuity (BCVA), keratometry values, thinnest corneal thickness (PachyMin) and topometric indexes were analysed preoperatively and at 6-month, 12-month, 18-month and 24-month postoperative. Progression was assessed by increase ≥ 1.00D in maximum keratometry (Kmax); increase ≥ 1.00D in corneal astigmatism; decrease ≥ 2% in PachyMin; increase ≥ 0.42 in D-index.Results: There were no complications during or after TE-ACXL. No significant differences (Δ) were observed between baseline and 12-month or 24-month postoperative: ∆BCVA (− 0.08 ± 0.25, p=0.190; − 0.04 ± 0.17, p=0.588), ∆Kmax (− 0.08 ± 1.32, p=0.792; − 1.04 ± 1.89, p=0.135), ∆Astigmatism (− 0.15 ± 0.89, p=0.485; − 0.24 ± 1.38, p=0.609), ∆PachyMin (− 0.56 ± 15.70, p=0.882; 0.56 ± 18.74, p=0.931), ∆Index Surface Variation (∆ISV) (− 2.11 ± 10.27, p=0.395; − 4.67 ± 17.32, p=0.442), ∆Index Vertical Asymmetry (∆IVA) (− 0.05 ± 0.17, p=0.208; − 0.08 ± 0.26, p=0.397), ∆Index Height Decentration (∆IHD) (0.00 ± 0.02, p=0.368; − 0.01 ± 0.04, p=0.484), ∆KI (0.00 ± 0.05, p=0.851; 0.01 ± 0.06, p=0.877) and ∆D-index (0.15 ± 1.14, p=0.572; 0.06 ± 1.36, p=0.892). Eleven to 33% of patients had disease progression at 24-month postoperative according to the parameters used to determine progression.Conclusion: Although some patients maintain disease progression, TE-ACXL seems to be a safe and effective treatment for keratoconus over the 2-year follow-up period. Studies with longer follow-up periods and larger patient cohorts are recommended.Keywords: cornea, keratoconus, disease progression, transepithelial, cross-linking
format	article
author	Cunha AM Sardinha T Torrão L Moreira R Falcão-Reis F Pinheiro-Costa J
author_facet	Cunha AM Sardinha T Torrão L Moreira R Falcão-Reis F Pinheiro-Costa J
author_sort	Cunha AM
title	Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
title_short	Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
title_full	Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
title_fullStr	Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
title_full_unstemmed	Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results
title_sort	transepithelial accelerated corneal collagen cross-linking: two-year results
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/07237454a397476a8a3903e3875319d0
work_keys_str_mv	AT cunhaam transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults AT sardinhat transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults AT torraol transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults AT moreirar transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults AT falcaoreisf transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults AT pinheirocostaj transepithelialacceleratedcornealcollagencrosslinkingtwoyearresults
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Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results

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