Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review

Ultraviolet crosslinking is a pathogenetically oriented method of treating primary and secondary corneal ectasias that cause irregular astigmatism and visual impairment. Advanced stage of the disease, when the initial thickness of the cornea is below 400 mc, is a contraindication to the use of the s...

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Autores principales: M. M. Bikbov, Iu. A. Rusakova, E. L. Usubov, E. M. Rakhimova
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Publicado: Scientific Сentre for Family Health and Human Reproduction Problems 2020
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spelling oai:doaj.org-article:c81692a076db40a698208de96b0273ce2021-11-23T06:14:45ZCrosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review2541-94202587-959610.29413/ABS.2020-5.5.10https://doaj.org/article/c81692a076db40a698208de96b0273ce2020-11-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/2444https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596Ultraviolet crosslinking is a pathogenetically oriented method of treating primary and secondary corneal ectasias that cause irregular astigmatism and visual impairment. Advanced stage of the disease, when the initial thickness of the cornea is below 400 mc, is a contraindication to the use of the standard «Dresden» protocol of the procedure. In such cases, it is possible to use modified UV crosslinking protocols. This article presents the modern crosslinking methods used for progressive keratoconus in advanced stages with a thin cornea. The presented methods are combined taking into account principled approaches – using additional tools and without them. Both approaches are based on a temporary artificial increase in the thickness of the cornea during the procedure in order to reduce the likelihood of damage to the deep layers of the cornea. The evolution of crosslinking protocols for thin corneas began with the use of hypoosmolar solutions that increase the thickness of the cornea to safe values. However, such an approach was not stable and the change in pachymetry parameters during the procedure created difficulties in its standardization. The use of different staff to increase the thickness of the cornea by providing an additional layer like a contact or biological lens seemed more encouraging. At the same time, the low permeability of these additional layers to oxygen, much needed for the UV crosslinking process of macromolecules, limited the overall effectiveness of the procedure. As a result of the progressive development of technologies and  the improvement of devices, the logical continuation of the trend of modifying the crosslinking protocol was the  introduction of an individual approach to customization of the protocol. The described modified protocols, taking into account the different principles of the surgical approach in ultraviolet radiation, set forth the results, evaluate their effectiveness and safety when applied to patients with a thin cornea.M. M. BikbovIu. A. RusakovaE. L. UsubovE. M. RakhimovaScientific Сentre for Family Health and Human Reproduction Problemsarticlecrosslinkinguv irradiationkeratoconusthin corneaScienceQRUActa Biomedica Scientifica, Vol 5, Iss 5, Pp 73-80 (2020)
institution DOAJ
collection DOAJ
language RU
topic crosslinking
uv irradiation
keratoconus
thin cornea
Science
Q
spellingShingle crosslinking
uv irradiation
keratoconus
thin cornea
Science
Q
M. M. Bikbov
Iu. A. Rusakova
E. L. Usubov
E. M. Rakhimova
Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
description Ultraviolet crosslinking is a pathogenetically oriented method of treating primary and secondary corneal ectasias that cause irregular astigmatism and visual impairment. Advanced stage of the disease, when the initial thickness of the cornea is below 400 mc, is a contraindication to the use of the standard «Dresden» protocol of the procedure. In such cases, it is possible to use modified UV crosslinking protocols. This article presents the modern crosslinking methods used for progressive keratoconus in advanced stages with a thin cornea. The presented methods are combined taking into account principled approaches – using additional tools and without them. Both approaches are based on a temporary artificial increase in the thickness of the cornea during the procedure in order to reduce the likelihood of damage to the deep layers of the cornea. The evolution of crosslinking protocols for thin corneas began with the use of hypoosmolar solutions that increase the thickness of the cornea to safe values. However, such an approach was not stable and the change in pachymetry parameters during the procedure created difficulties in its standardization. The use of different staff to increase the thickness of the cornea by providing an additional layer like a contact or biological lens seemed more encouraging. At the same time, the low permeability of these additional layers to oxygen, much needed for the UV crosslinking process of macromolecules, limited the overall effectiveness of the procedure. As a result of the progressive development of technologies and  the improvement of devices, the logical continuation of the trend of modifying the crosslinking protocol was the  introduction of an individual approach to customization of the protocol. The described modified protocols, taking into account the different principles of the surgical approach in ultraviolet radiation, set forth the results, evaluate their effectiveness and safety when applied to patients with a thin cornea.
format article
author M. M. Bikbov
Iu. A. Rusakova
E. L. Usubov
E. M. Rakhimova
author_facet M. M. Bikbov
Iu. A. Rusakova
E. L. Usubov
E. M. Rakhimova
author_sort M. M. Bikbov
title Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
title_short Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
title_full Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
title_fullStr Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
title_full_unstemmed Crosslinking of Thin Corneas: a Modern Vision of the Problem. Literature Review
title_sort crosslinking of thin corneas: a modern vision of the problem. literature review
publisher Scientific Сentre for Family Health and Human Reproduction Problems
publishDate 2020
url https://doaj.org/article/c81692a076db40a698208de96b0273ce
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AT iuarusakova crosslinkingofthincorneasamodernvisionoftheproblemliteraturereview
AT elusubov crosslinkingofthincorneasamodernvisionoftheproblemliteraturereview
AT emrakhimova crosslinkingofthincorneasamodernvisionoftheproblemliteraturereview
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