Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols

Julio C Hernandez-Camarena,1 Enrique O Graue-Hernandez,2 Denise Loya-García,1 Raul E Ruiz-Lozano,1 Jorge E Valdez-García11Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL 64710, Mexico; 2Department of Cornea and Refractive Surgery, Institute o...

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Autores principales:	Hernandez-Camarena JC, Graue-Hernandez EO, Loya-García D, Ruiz-Lozano RE, Valdez-García JE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	keratoconus accelerated corneal crosslinking corneal stromal demarcation line optical coherence tomography topographic stabilization Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/30a1158a3ada4d9cb0301aca319fa8dd
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spelling	oai:doaj.org-article:30a1158a3ada4d9cb0301aca319fa8dd2021-12-02T08:29:39ZCorrelation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols1177-5483https://doaj.org/article/30a1158a3ada4d9cb0301aca319fa8dd2019-08-01T00:00:00Zhttps://www.dovepress.com/correlation-between-corneal-stromal-demarcation-line-depth-and-topogra-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Julio C Hernandez-Camarena,1 Enrique O Graue-Hernandez,2 Denise Loya-García,1 Raul E Ruiz-Lozano,1 Jorge E Valdez-García11Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL 64710, Mexico; 2Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico City, MexicoCorrespondence: Julio C Hernandez-CamarenaCornea and Refractive Surgery Service, Zambrano-Hellion Hospital, Batallon de San Patricio 112, 1st Floor East, Real de San Agustín, San Pedro Garza Garcia, Nuevo Leon 66278, MexicoTel +52 1 818 888 0550Fax +52 1 818 888 0555Email dr.juliohernandez@medicos.tecsalud.mxPurpose: To report the visual and topographic outcomes of two pulsed-light-accelerated CXL (A-CXL) protocols at a 12-month follow-up and their correlation with the corneal stromal demarcation line (DL) depth.Patients and methods: Retrospective comparative cohort of patients with documented progressive keratoconus were included. Two epi-off pulsed-light [1s on–1s off] A-CXL protocols were compared: irradiance 308 and 455:20 (fluence 7.2 J/cm2,). UDVA, CDVA, spherical equivalent (SE), topographic astigmatism, Kmin, Kmax, Km, central corneal thickness (CCT), thinnest pachymetry (TCT) and endothelial cell density (ECD) were measured preoperatively and months 1, 3, 6 and 12 postoperative. Corneal DL was measured 1 month postoperatively using anterior segment optical coherence tomography.Results: Fifty eyes (27 patients): 22 eyes in group A-CXL (308), 28 eyes in group A-CXL (455:20). Mean age (years) was 19.04±4.71 and 20.32±4.57. DL depth (μm) at month 1 was 200.63±10.01 μm and 184.53±19.68 μm for group A-CXL (308) and group A-CXL (455:20), respectively (p<0.001). Significant improvement in CDVA, topographic astigmatism, Kmin, Kmax and Km was observed in both groups (no significant difference between groups) and no significant changes were observed in CCT, TCT and ECD with regard to baseline. Over 85% of the eyes in both protocols achieved stabilization or improvement in maximum K at the end of the follow-up. No significant correlations between DL and any visual or topographic outcomes were observed at 12 months.Conclusion: No correlation between DL depth and visual or topographic outcomes was observed on either protocol. Although significant improvement on CDVA, topographic astigmatism, Kmin, Kmax and Km was observed in both groups at 12 months, further research is needed to assure safety and effectiveness at stabilizing keratoconus progression.Keywords: keratoconus, accelerated corneal crosslinking, corneal stromal demarcation line, optical coherence tomography, topographic stabilization  Hernandez-Camarena JCGraue-Hernandez EOLoya-García DRuiz-Lozano REValdez-García JEDove Medical Pressarticlekeratoconusaccelerated corneal crosslinkingcorneal stromal demarcation lineoptical coherence tomographytopographic stabilizationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1665-1673 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	keratoconus accelerated corneal crosslinking corneal stromal demarcation line optical coherence tomography topographic stabilization Ophthalmology RE1-994
spellingShingle	keratoconus accelerated corneal crosslinking corneal stromal demarcation line optical coherence tomography topographic stabilization Ophthalmology RE1-994 Hernandez-Camarena JC Graue-Hernandez EO Loya-García D Ruiz-Lozano RE Valdez-García JE Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
description	Julio C Hernandez-Camarena,1 Enrique O Graue-Hernandez,2 Denise Loya-García,1 Raul E Ruiz-Lozano,1 Jorge E Valdez-García11Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL 64710, Mexico; 2Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico City, MexicoCorrespondence: Julio C Hernandez-CamarenaCornea and Refractive Surgery Service, Zambrano-Hellion Hospital, Batallon de San Patricio 112, 1st Floor East, Real de San Agustín, San Pedro Garza Garcia, Nuevo Leon 66278, MexicoTel +52 1 818 888 0550Fax +52 1 818 888 0555Email dr.juliohernandez@medicos.tecsalud.mxPurpose: To report the visual and topographic outcomes of two pulsed-light-accelerated CXL (A-CXL) protocols at a 12-month follow-up and their correlation with the corneal stromal demarcation line (DL) depth.Patients and methods: Retrospective comparative cohort of patients with documented progressive keratoconus were included. Two epi-off pulsed-light [1s on–1s off] A-CXL protocols were compared: irradiance 308 and 455:20 (fluence 7.2 J/cm2,). UDVA, CDVA, spherical equivalent (SE), topographic astigmatism, Kmin, Kmax, Km, central corneal thickness (CCT), thinnest pachymetry (TCT) and endothelial cell density (ECD) were measured preoperatively and months 1, 3, 6 and 12 postoperative. Corneal DL was measured 1 month postoperatively using anterior segment optical coherence tomography.Results: Fifty eyes (27 patients): 22 eyes in group A-CXL (308), 28 eyes in group A-CXL (455:20). Mean age (years) was 19.04±4.71 and 20.32±4.57. DL depth (μm) at month 1 was 200.63±10.01 μm and 184.53±19.68 μm for group A-CXL (308) and group A-CXL (455:20), respectively (p<0.001). Significant improvement in CDVA, topographic astigmatism, Kmin, Kmax and Km was observed in both groups (no significant difference between groups) and no significant changes were observed in CCT, TCT and ECD with regard to baseline. Over 85% of the eyes in both protocols achieved stabilization or improvement in maximum K at the end of the follow-up. No significant correlations between DL and any visual or topographic outcomes were observed at 12 months.Conclusion: No correlation between DL depth and visual or topographic outcomes was observed on either protocol. Although significant improvement on CDVA, topographic astigmatism, Kmin, Kmax and Km was observed in both groups at 12 months, further research is needed to assure safety and effectiveness at stabilizing keratoconus progression.Keywords: keratoconus, accelerated corneal crosslinking, corneal stromal demarcation line, optical coherence tomography, topographic stabilization
format	article
author	Hernandez-Camarena JC Graue-Hernandez EO Loya-García D Ruiz-Lozano RE Valdez-García JE
author_facet	Hernandez-Camarena JC Graue-Hernandez EO Loya-García D Ruiz-Lozano RE Valdez-García JE
author_sort	Hernandez-Camarena JC
title	Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
title_short	Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
title_full	Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
title_fullStr	Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
title_full_unstemmed	Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
title_sort	correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/30a1158a3ada4d9cb0301aca319fa8dd
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Correlation between corneal stromal demarcation line depth and topographic outcomes after two pulsed-light-accelerated crosslinking protocols

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