$Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia$
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Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia

Wee Kiak Lim,1,2 Zhi Da Soh,1 Harold Kah Yen Choi,1 Julian Thiam Siew Theng1,3 1Eagle Eye Centre, Mount Alvernia Hospital, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Department of Ophthalmology, Khoo Teck Puat Hospital, Singapore Purpose: To report the 9–12-month outcomes of...

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Autores principales:	Lim WK, Soh ZD, Choi HKY, Theng JTS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	PiXL Cornea Collagen Cross-linking Low myopia correction Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/70aa5a4b3b15443f8e8681e85d981a48
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spelling	oai:doaj.org-article:70aa5a4b3b15443f8e8681e85d981a482021-12-02T07:35:32ZEpithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia1177-5483https://doaj.org/article/70aa5a4b3b15443f8e8681e85d981a482017-06-01T00:00:00Zhttps://www.dovepress.com/epithelium-on-photorefractive-intrastromal-cross-linking-pixl-for-redu-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Wee Kiak Lim,1,2 Zhi Da Soh,1 Harold Kah Yen Choi,1 Julian Thiam Siew Theng1,3 1Eagle Eye Centre, Mount Alvernia Hospital, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Department of Ophthalmology, Khoo Teck Puat Hospital, Singapore Purpose: To report the 9–12-month outcomes of a novel procedure for reduction of low myopia through epithelium-on photorefractive intrastromal cross-linking (PiXL) with customized control of topographic distribution of ultraviolet (UV)-fluence. Method: Myopic patients with normal (non-ectatic) corneas underwent the PiXL procedure for reduction of low myopia. PiXL treatments were delivered through selective application of UVA light based on the refractive error of each patient. Clinical evaluation included safety (corrected distance visual acuity, endothelial cell count, central corneal thickness, anterior ocular health) and efficacy (uncorrected distance visual acuity, manifest refraction, K-mean) examinations. In addition, a patient satisfaction survey was conducted at 9 months post-procedure to evaluate patients’ subjective experience with the procedure. Results: Fourteen myopic eyes (mean manifest refraction spherical equivalent –1.62±0.6D; range –0.75 to –2.65D) of 8 subjects (mean age 30 years old; range 24–51 years old) were enrolled in the study. At 12 months post-procedure, a mean manifest refraction spherical equivalent reduction of 0.72±0.43D (P<0.001) was observed, with a corresponding gain in uncorrected visual acuity of 0.25 logMAR and mean K-mean flattening of 0.47±0.46D. All patients achieved best corrected visual acuity of 20/20 or better from 1 month onward. There were no cases of ocular infection or secondary changes to the crystalline lens and retina due to UV exposure, while transient corneal haze subsided gradually. Conclusion: The epithelium-on PiXL procedure was safe and effective in reducing myopic refractive error in this study with up to 12 months follow-up. Early results of this novel application of collagen cross-linking are encouraging but longer-term data in larger studies are required. Precis: This paper serves to introduce and report the early clinical results of epithelium-on PiXL, a novel application of cornea cross-linking, in reducing low myopia in Asian eyes, which are under-represented in studies of similar design. Keywords: PiXL, cornea collagen cross-linking, low myopia correction Lim WKSoh ZDChoi HKYTheng JTSDove Medical PressarticlePiXLCornea Collagen Cross-linkingLow myopia correctionOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1205-1211 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	PiXL Cornea Collagen Cross-linking Low myopia correction Ophthalmology RE1-994
spellingShingle	PiXL Cornea Collagen Cross-linking Low myopia correction Ophthalmology RE1-994 Lim WK Soh ZD Choi HKY Theng JTS Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
description	Wee Kiak Lim,1,2 Zhi Da Soh,1 Harold Kah Yen Choi,1 Julian Thiam Siew Theng1,3 1Eagle Eye Centre, Mount Alvernia Hospital, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Department of Ophthalmology, Khoo Teck Puat Hospital, Singapore Purpose: To report the 9–12-month outcomes of a novel procedure for reduction of low myopia through epithelium-on photorefractive intrastromal cross-linking (PiXL) with customized control of topographic distribution of ultraviolet (UV)-fluence. Method: Myopic patients with normal (non-ectatic) corneas underwent the PiXL procedure for reduction of low myopia. PiXL treatments were delivered through selective application of UVA light based on the refractive error of each patient. Clinical evaluation included safety (corrected distance visual acuity, endothelial cell count, central corneal thickness, anterior ocular health) and efficacy (uncorrected distance visual acuity, manifest refraction, K-mean) examinations. In addition, a patient satisfaction survey was conducted at 9 months post-procedure to evaluate patients’ subjective experience with the procedure. Results: Fourteen myopic eyes (mean manifest refraction spherical equivalent –1.62±0.6D; range –0.75 to –2.65D) of 8 subjects (mean age 30 years old; range 24–51 years old) were enrolled in the study. At 12 months post-procedure, a mean manifest refraction spherical equivalent reduction of 0.72±0.43D (P<0.001) was observed, with a corresponding gain in uncorrected visual acuity of 0.25 logMAR and mean K-mean flattening of 0.47±0.46D. All patients achieved best corrected visual acuity of 20/20 or better from 1 month onward. There were no cases of ocular infection or secondary changes to the crystalline lens and retina due to UV exposure, while transient corneal haze subsided gradually. Conclusion: The epithelium-on PiXL procedure was safe and effective in reducing myopic refractive error in this study with up to 12 months follow-up. Early results of this novel application of collagen cross-linking are encouraging but longer-term data in larger studies are required. Precis: This paper serves to introduce and report the early clinical results of epithelium-on PiXL, a novel application of cornea cross-linking, in reducing low myopia in Asian eyes, which are under-represented in studies of similar design. Keywords: PiXL, cornea collagen cross-linking, low myopia correction
format	article
author	Lim WK Soh ZD Choi HKY Theng JTS
author_facet	Lim WK Soh ZD Choi HKY Theng JTS
author_sort	Lim WK
title	Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
title_short	Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
title_full	Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
title_fullStr	Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
title_full_unstemmed	Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia
title_sort	epithelium-on photorefractive intrastromal cross-linking (pixl) for reduction of low myopia
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/70aa5a4b3b15443f8e8681e85d981a48
work_keys_str_mv	AT limwk epitheliumonphotorefractiveintrastromalcrosslinkingpixlforreductionoflowmyopia AT sohzd epitheliumonphotorefractiveintrastromalcrosslinkingpixlforreductionoflowmyopia AT choihky epitheliumonphotorefractiveintrastromalcrosslinkingpixlforreductionoflowmyopia AT thengjts epitheliumonphotorefractiveintrastromalcrosslinkingpixlforreductionoflowmyopia
_version_	1718399343425224704

Epithelium-on photorefractive intrastromal cross-linking (PiXL) for reduction of low myopia

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