Long-term results of corneal collagen crosslinking with ectatic forms of corneal dystrophy

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Abstract

Corneal collagen crosslinking is one of the most effective methods of prophylactics and treatment of progressive corneal ectasias. In the literature, there are occasional data related to remote results concerning only the most common form of ectasias – keratoconus. In published studies, no remote results are met concerning the efficacy of corneal collagen crosslinking in other forms of corneal ectasias, which are now on the rise, including secondary ectasias that became more frequent with refractive surgery. The number of diagnosed cases of pellucid marginal degeneration increased as well. The literature shows no data on comparative analysis of remote results concerning the efficacy of this method in treatment of various forms of corneal ectasias.

The aim of the investigation was to evaluate the efficacy of corneal collagen crosslinking based on the analysis of long-term results of this treatment method for various forms of corneal ectasias.

Materials and methods. The results of corneal collagen crosslinking in patients with various forms of corneal ectasia 6 years after surgery were analyzed. The nosological structure of the study included patients with keratoconus, pellucid marginal degeneration, and secondary ectasia. The group of patients with keratoconus included 30 patients (30 eyes), that with pellucid marginal degeneration – 30 patients (30 eyes), and that with secondary ectasia – 30 patients (30 eyes). Corneal collagen crosslinking was performed by the same specialist, during the first or the second year of follow-up. Then changes in the state of the cornea and visual functions were monitored for 6 years. To assess the efficacy, preoperative examination results and interim data were used.

Results. In all groups, there was an increase in the best corrected visual acuity, a decrease in the index of asymmetry of the corneal surface and its refractive power in the center of ectasia. However, best corneal collagen crosslinking results were obtained in groups of patients with keratoconus and secondary corneal ectasia.

About the authors

Oleg A. Frolov

Diagnostic Center No. 7 (Eye) for Adults and Children; Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: oleg524@mail.ru

Post-Graduate Student, Department of Ophthalmology with the Clinic; Head of the Department of Complex Optical Correction

Russian Federation, Saint Petersburg

Sergey Yu. Astakhov

Pavlov First Saint Petersburg State Medical University

Email: astakhov73@mail.ru

MD, PhD, DMedSc, Professor, Head of Ophthalmology Department

Russian Federation, Saint Petersburg

Sergey A. Novikov

Pavlov First Saint Petersburg State Medical University

Email: serg2705@yandex.ru

MD, PhD, DMedSc, Professor, Ophthalmology Department

Russian Federation, Saint Petersburg

References

  1. Бикбов М.М., Бикбова Г.М. Эктазии роговицы (патогенез, патоморфология, клиника, диагностика, лечение). – М.: Офтальмология, 2011. – 168 с. [Bikbov MM, Bikbova GM. Ektazii rogovitsy (patogenez, patomorfologiya, klinika, diagnostika, lecheniye). Moscow: Oftal’mologiya; 2011. 168 р. (In Russ.)]
  2. Бикбов М.М., Халимов А.Р., Усубов Э.Л. Ультрафиолетовый кросслинкинг роговицы // Вестник РАМН. – 2016. – Т. 71. – № 3. – С. 224–232. [Bikbov MM, Khalimov AR, Usubov EL. Ultraviolet corneal crosslinking. Annals of the Russian Academy of Medical Sciences. 2016;71(3):224-232. (In Russ.)]. https://doi.org/10.15690/vramn562.
  3. Новиков C.А., Кольцов А.А., Данилов П.А., Федотова К. К вопросу о стандартизации и оптимизации офтальмологического обследования пациентов // Современная оптометрия. – 2016. – № 10. – С. 30–49. [Novikov SA, Koltsov AA, Danilov PA, Fedotova K. About standardization and optimization of vision examination procedure. Actual Optometry. 2016;(10):30-49. (In Russ.)]
  4. Слонимский А.Ю. Тактика ведения больных при остром кератоконусе // РМЖ. Клиническая офтальмология. – 2004. – Т. 5. – № 2. – С. 75–77. [Slonimskiy AYu. Taktika vedeniya bol’nykh pri ostrom keratokonuse. RMZh. Klinicheskaya oftal’mologiya. 2004;5(2):75-77. (In Russ.)]
  5. Нероев В.В., Петухова А.Б., Гундорова Р.А., Оганесян О.Г. Сферы клинического применения кросслинкинга роговичного коллагена // Практическая медицина. – 2012. – № 4–1. – С. 72–74. [Neroev VV, Petukhova AB, Gundorova RA, Oganesyan OG. Sphere of clinical application of corneal collagen cross-linking. Practical Medicine. 20124;(4-1):72-74. (In Russ.)]
  6. Gordon MO, Steger-May K, Szczotka-Flynn L, et al. Baseline factors predictive of incident penetrating keratoplasty in keratoconus. Am J Ophthalmol. 2006;142(6):923-930. https://doi.org/10.1016/j.ajo.2006.07.026.
  7. Raiskup-Wolf F, Hoyer A, Spoerl E, Pillunat LE. Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg. 2008;34(5):796-801. https://doi.org/10.1016/j.jcrs.2007.12.039.
  8. Edwards M, Clover GM, Brookes N, et al. Indications for corneal transplantation in New Zealand: 1991-1999. Cornea. 2002;21(2): 152-155. https://doi.org/10.1097/00003226-200203000-00004.
  9. Kymionis GD, Portaliou DM, Diakonis VF, et al. Management of post laser in situ keratomileusis ectasia with simultaneous topography guided photorefractive keratectomy and collagen cross-linking. Open Ophthalmol J. 2011;5:11-13. https://doi.org/10.2174/1874364101105010011.
  10. Panos GD, Hafezi F, Gatzioufas Z. Pellucid marginal degeneration and keratoconus; differential diagnosis by corneal topography. J Cataract Refract Surg. 2013;39(6):968. https://doi.org/10.1016/j.jcrs.2013.04.020.
  11. Millodot M, Shneor E, Albou S, et al. Prevalence and associated factors of keratoconus in jerusalem: a cross- sectional study. Ophthalmic Epidemiol. 2011;18(2):91-97. https://doi.org/10.3109/09286586.2011.560747.
  12. Rabinowitz YS. Keratoconus. Survey of Ophthalmology. 1998;42(4): 297-319. https://doi.org/10.1016/s0039-6257(97)00119-7.
  13. Raiskup F, Hoyer A, Spoerl E. Permanent corneal haze after riboflavin-UVA – induced cross-linking in keratoconus. J Refract Surg. 2009;25(9): S824-828. https://doi.org/10.3928/1081597X-20090813-12.
  14. Rizopoulos D. Joint models for longitudinal and time-to-event data: with applications in R (Chapman & Hall/CRC Biostatistics Series, Book 6). Chapman and Hall/CRC; 2012. 275 p.
  15. Spadea L. Corneal collagen cross-linking with riboflavin and UVA irradiation in pellucid marginal degeneration. J Refract Surg. 2010;26: 375-377. https://doi.org/10.3928/1081597x-20100114-03.
  16. Spoerl E, Wollensak G, Seiler T. Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res. 2004;29(1):35-40. https://doi.org/10.1080/02713680490513182.
  17. Spoerl E, Wollensak G, Dittert DD, Seiler T. Thermomechanical behavior of collagen-cross-linked porcine cornea. Ophthalmologica. 2004;218(2):136-140. https://doi.org/10.1159/ 000076150.
  18. Owens H, Gamble GD, Bjornholdt MC, et al. Topographic indications of emerging keratoconus in teenage New Zealanders. Cornea. 2007;26(3):312-318. https://doi.org/10.1097/ICO. 0b013e31802f8d87.
  19. Wollensak G. Crosslinking treatment of progressive keratoconus: new hope. Curr Opin Ophthalmol. 2006;17(4):356-360. https://doi.org/10.1097/01.icu.0000233954.86723.25.
  20. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003;135(5):620-627. https://doi.org/10.1016/s0002-9394(02)02220-1.
  21. Ziaei M, Barsam A, Shamie N, et al; ASCRS Cornea Clinical Committee. Reshaping procedures for the surgical management of corneal ectasia. J Cataract Refract Surg. 2015;41(4):842-872. https://doi.org/10.1016/j.jcrs.2015.03.010.

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2. Fig. 1. The dynamics of the most corrected visual acuity

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3. Fig. 2. The dynamics of the refractive power of the cornea in the center of ectasia

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4. Fig. 3. The dynamics of the topographic index of the asymmetry of the cornea

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Copyright (c) 2020 Frolov O.A., Astakhov S.Y., Novikov S.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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