Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas

Leopoldo Spadea,1 Rita Mencucci21University of L&#39;Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L&#39;Aquila, 2University of Florence, Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, Florence, ItalyBackground: The purpose...

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Autores principales:	Spadea L, Mencucci R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/98087218402b4e149cfe26a7274faf07
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spelling	oai:doaj.org-article:98087218402b4e149cfe26a7274faf072021-12-02T06:30:21ZTransepithelial corneal collagen cross-linking in ultrathin keratoconic corneas1177-54671177-5483https://doaj.org/article/98087218402b4e149cfe26a7274faf072012-11-01T00:00:00Zhttp://www.dovepress.com/transepithelial-corneal-collagen-cross-linking-in-ultrathin-keratoconi-a11424https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Leopoldo Spadea,1 Rita Mencucci21University of L&#39;Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L&#39;Aquila, 2University of Florence, Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, Florence, ItalyBackground: The purpose of this paper was to report the results of transepithelial corneal collagen cross-linking (CXL) with modified riboflavin and ultraviolet A irradiation in patients affected by keratoconus, each with thinnest pachymetry values of less than 400 &micro;m (with epithelium) and not treatable using standard de-epithelialization techniques.Methods: Sixteen patients affected by progressive keratoconus with thinnest pachymetry values ranging from 331 &micro;m to 389 &micro;m underwent transepithelial CXL in one eye using a riboflavin 0.1% solution in 15% Dextran T500 containing ethylenediamine tetra-acetic acid 0.01% and trometamol to enhance epithelial penetration. The patients underwent complete ophthalmological examination, including endothelial cell density measurements and computerized videokeratography, before CXL and at one day, one week, and one, 6, and 12 months thereafter.Results: Epithelial healing was complete in all patients after one day of use of a soft bandage contact lens. No side effects or damage to the limbal region was observed during the follow-up period. All patients showed slightly improved uncorrected and spectacle-corrected visual acuity; keratometric astigmatism showed reductions (up to 5.3 D) and apical ectasia power decreased (Kmax values reduced up to 4.3 D). Endothelial cell density was unchanged.Conclusion: Application of transepithelial CXL using riboflavin with substances added to enhance epithelial permeability was safe, seemed to be moderately effective in keratoconic eyes with ultrathin corneas, and applications of the procedure could be extended to patients with advanced keratoconus.Keywords: keratoconus, pachymetry, topography, transepithelial corneal collagen cross-linking, thin corneaSpadea LMencucci RDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1785-1792 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Spadea L Mencucci R Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
description	Leopoldo Spadea,1 Rita Mencucci21University of L&#39;Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L&#39;Aquila, 2University of Florence, Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, Florence, ItalyBackground: The purpose of this paper was to report the results of transepithelial corneal collagen cross-linking (CXL) with modified riboflavin and ultraviolet A irradiation in patients affected by keratoconus, each with thinnest pachymetry values of less than 400 &micro;m (with epithelium) and not treatable using standard de-epithelialization techniques.Methods: Sixteen patients affected by progressive keratoconus with thinnest pachymetry values ranging from 331 &micro;m to 389 &micro;m underwent transepithelial CXL in one eye using a riboflavin 0.1% solution in 15% Dextran T500 containing ethylenediamine tetra-acetic acid 0.01% and trometamol to enhance epithelial penetration. The patients underwent complete ophthalmological examination, including endothelial cell density measurements and computerized videokeratography, before CXL and at one day, one week, and one, 6, and 12 months thereafter.Results: Epithelial healing was complete in all patients after one day of use of a soft bandage contact lens. No side effects or damage to the limbal region was observed during the follow-up period. All patients showed slightly improved uncorrected and spectacle-corrected visual acuity; keratometric astigmatism showed reductions (up to 5.3 D) and apical ectasia power decreased (Kmax values reduced up to 4.3 D). Endothelial cell density was unchanged.Conclusion: Application of transepithelial CXL using riboflavin with substances added to enhance epithelial permeability was safe, seemed to be moderately effective in keratoconic eyes with ultrathin corneas, and applications of the procedure could be extended to patients with advanced keratoconus.Keywords: keratoconus, pachymetry, topography, transepithelial corneal collagen cross-linking, thin cornea
format	article
author	Spadea L Mencucci R
author_facet	Spadea L Mencucci R
author_sort	Spadea L
title	Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
title_short	Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
title_full	Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
title_fullStr	Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
title_full_unstemmed	Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
title_sort	transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/98087218402b4e149cfe26a7274faf07
work_keys_str_mv	AT spadeal transepithelialcornealcollagencrosslinkinginultrathinkeratoconiccorneas AT mencuccir transepithelialcornealcollagencrosslinkinginultrathinkeratoconiccorneas
_version_	1718399889799380992

Transepithelial corneal collagen cross-linking in ultrathin keratoconic corneas

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