Current Trends and Complications of Corneal Collagen Cross Linking in Keratoconus | Chapter 3 | Current Practice in Medical Science Vol. 5

 

Evaluation of the safety profile and existing Corneal Cross Linking methods.

Methods: The well-established method of collagen cross-linking (CXL) can stop the growth of keratoconus. In all currently in use techniques, riboflavin instillation is followed by ultraviolet-A (UV-A) radiation. Currently, epithelium on and epithelium off procedures, as well as accelerated approaches using different doses of irradiation, are used in clinical practice. Each approach has resulted in some reported difficulties.

In summary, the multiplicity of CXL regimens gives clinicians the flexibility to treat each patient uniquely. Both early and late difficulties need to be handled right away.

Author(s) Details:

Atzamoglou Spyridon,
Ophthalmiatrion Athinon, Sina 2, 10672, Athens, Greece.

Kontomichos Loukas,
Ophthalmiatrion Athinon, Sina 2, 10672, Athens, Greece.

Parikakis Efstratios,
Ophthalmiatrion Athinon, Sina 2, 10672, Athens, Greece.

Peponis Vasileios,
Ophthalmiatrion Athinon, Sina 2, 10672, Athens, Greece.

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Study about Corneal Collagen Cross-Linking Mushroom Shape Demarcation Line Profile after Limited Bowman’s Membrane Removal by Phototherapeutic Keratectomy | Chapter 14 | New Horizons in Medicine and Medical Research Vol. 4

 A instance of keratoconus was treated using mechanical epithelial debridement (at an 8.5 mm zone), limited PTK (at a 5.0 mm zone and 10 m depth), and CXL. The removal of the Bowman's layer resulted in a mushroom-shaped demarcation line profile on AS-OCT, showing that the removal of the Bowman's layer may have contributed to the increased depth of the corneal stromal demarcation line.

Mechanical epithelial debridement (at an 8.5 mm zone), PTK (at a 5.0 mm zone and in a 10 m depth), and CXL were performed on a twenty-one-year-old male with progressive keratoconus. There were no intraoperative or early postoperative problems discovered. Anterior segment optical coherence tomography indicated a mushroom-shaped profile in the corneal stromal demarcation line depth.

The loss of Bowman's layer appears to result in a deeper corneal stromal demarcation line. Bowman's removal could result in corneal thinning as a result of increased evaporation. Despite the fact that the significance of Bowman's layer in the CXL technique is uncertain, this finding suggests that removing it could increase the depth of CXL therapy.


Author(S) Details

George D. Kymionis
Department of Medicine, Institute of Vision and Optics, University of Crete, Heraklion, Crete, Greece and Bascom Palmer Eye Institute, University of Miami, Miller school of Medicine, Miami, Florida, USA.

Michael A. Grentzelos
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Nektarios E. Klados
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Niki A. Xanthopoulou
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Theodore A. Paraskevopoulos
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.

Efstathios T. Detorakis
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.


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Conventional and Accelerated “epi-off” Corneal Crosslinking-UVA Procedure in the Treatment of Progressive Keratoconus | Chapter 13 | Current Topics in Medicine and Medical Research Vol. 12

Keratoconus (KCN) is a bilateral, sometimes asymmetric, ectatic corneal condition with gradual thinning of the cornea, leading to protrusion, progressive irregular astigmatism, and visual impairment. Early identification of KCN using the Pentacam device's topographical and tomographic assessment is of significant importance. The standard treatment for KCN therapy is corneal collagen cross-linking (CXL). The final result of the CXL technique is corneal reinforcement, with the goal of slowing or halting the development of KCN, thus preventing or at least delaying the need for keratoplasty. With a low risk profile, CXL is a promising technique. The traditional cross-linking "epi-off" is considered to have long-term efficacy in stabilizing progressive KCN. An accelerated "epi-off" CXL procedure has been implemented lately. We concluded that both normal and accelerated "epi-off" procedures are successful and secure, contributing to keratoconus stabilization.

Author (s) Details

Cristina Ariadna Nicula
Department of Ophthalmology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj- Napoca, Romania and Oculens Clinic, Cluj-Napoca, Romania.

Dorin Nicula
Oculens Clinic, Cluj-Napoca, Romania.

Anca Maria Rednik
County Eye Hospital Cluj-Napoca, Romania.

Adriana Elena Bulboaca
Department of Physiopathology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj- Napoca, Romania.

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