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SPECIFIC CORNEAL PARAMETERS AND VISUAL ACUITY CHANGES AFTER CORNEAL CROSSLINKING TREATMENT FOR PROGRESSIVE KERATOCONUS


Authors: P. Veselý 1,3;  Ľ. Veselý 2;  V. Combová 1;  M. Žukovič 4
Authors‘ workplace: VESELY, očná klinika – Bratislava, výučbové pracovisko pre refrakčnú a laserovú chirurgiu Lekárskej fa-kulty Univerzity Komenského, Bratislava 1;  Oční klinika Fakultní nemocnice Královské Vinohrady, Praha 2;  Klinika oftalmológie Lekárskej fakulty Univerzity Komenského a Univerzitnej nemocnice, Nemocnica Ru-žinov, Bratislava 3;  Risk Intelligence Analytics, Dell Technologies, Praha 4
Published in: Čes. a slov. Oftal., 77, 2021, No. 4, p. 184-189
Category: Original Article
doi: https://doi.org/10.31348/2021/21

Overview

Aim: To evaluate the effect of crosslinking (CXL) therapy on the change in the quality of visual acuity and the change in the topographic properties of the cornea – curvature, pachymetry, and change of astigmatism, coma abberation and CLMIaa (Cone Localisation and Magnitude Index).

Methods: A retrospective analytical study included 29 eyes of 24 patients who had progressed in the last 12 months and were suitable candidates for CXL surgery. The monitored parameters were the steepest, flatest and mean anterior instantaneous curvature (AICS, AICF, AICM) and the steepest, flatest and mean posterior instantaneous curvature (PICS, PICF, PICM) of the cornea, corneal thickness in the centre of the cornea (PACHC) and in the thinnest point of the cornea (PACHT), corneal astigmatism (ASTIG). coma (COMA), Cone Localization and Magnitude Index (CLMIaa) and uncorrected distance visual acuity (UDVA) with corrected distance visual acuity (CDVA). Data were analysed before surgery and 12 months after surgery. The AIC, COMA, CLMIaa and ASTIG parameters were analysed by paired t test. As the parameters of UDVA, CDVA, PIC and PACH did not meet the conditions of normal distribution, the Wilcoxon test was used to investigate the change in these parameters after CXL.

Results: Twelve months after the procedure, we recorded an improvement in UDVA (p = 0.371) and CDVA (p = 0.825), an increase in PICS, PICF and PICM (p = 0.902; p = 0.87 and p = 0.555), a decrease in PACHCC (p = 0.294) and a decrease in CLMIaa (p = 0.113) that did not reach statistical significance. The decrease in PACHT (p = 0.027), decrease in COMA (p = 0.037) and decrease in anterior corneal curvature of AICS, AICF and AICM were statistically significant (p = 0.019; p = 0.010 and p = 0.005). The decrease in the value of astigmatism did not show statistical significance, as p = 0.297.

Conclusion: CXL corneal therapy has been shown to be an effective method to stabilize the cornea in progressive keratoconus, and to improve the higher order of coma. This contributes to the possible improvement of UDVA and CDVA.

Keywords:

Cornea – ectasia – CXL – pachymetry – anterior instantaneous curvature – posterior instantaneous curvature – Coma – CLMIaa


Sources
  1. Kuchynka P, et al. Oční lékařství. 1st ed. Praha (Česká republika): Grada Publishing, a.s.; 2007. Chapter 8, Rohovka;p 224.
  2. Veselý Ľ, Choroby oka. 2. vydanie Martin (Československo): Osveta, n.p.; 1973. Chapter 6, Choroby rohovky;p 110.
  3. Rabinowitz YS. Keratoconus. Surv. Ophthalmol. 1998;42:297-319.
  4. Pantanelli S, MacRae S, Jeong TM, Yoon G. Characterizing the Wave Aberration in Eyes with Keratoconus or Penetrating Keratoplasty Using a High-Dynamic Range Wavefront Sensor. Ophthalmology. 2007;114:2013-2021.
  5. Seiler T, Hafezi F. Corneal Cross-Linking-Induced Stromal Demarcation Line. Cornea. 2006;25:1057-1059.
  6. 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;34:796-801.
  7. Greenstein SA, Fry KL, Hersh PS. Corneal topography indices after corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg 2011;37:1282-1290.
  8. Derakhshan A, Shandiz JH, Ahadi M, Daneshvar R, Esmaily H. Short-term outcomes of collagen crosslinking for early keratoconus. J Ophthalmic Vis Res 2011;6:155-159.
  9. Sedaghat M, Bagheri M, Ghavami S, Bamdas S. Changes in corneal topography and biomechanical properties after collagen cross linking for keratoconus: 1-year results. The Middle East Afr J Ophthalmol 2015;2:212-219.
  10. Asri D, Touboul D, Fournié P et al. Corneal collagen crosslinking in progressive keratoconus: Multicenter results from the French National Reference Center for Keratoconus. J Cataract Refract Surg 2011;37:2137-43.
  11. Vinciguerra P, Albè E, Trazza S et al. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology 2009;116:369-78.
  12. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 2003;135:620-7
  13. Greenstein SA, Shah VP, Fry KL, Hersh PS. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg 2011;37:691-700.
  14. Caporossi A, Mazzotta C, Baiocchi S, Caporossi T. Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study. Am J Ophthalmol. 2010 Apr;149(4):585-93. doi: 10.1016/j.ajo.2009.10.021
  15. Strmeňová E, Vlková E, Michalcová L, et al. Corneal cross-linking v liečbe keratokónusu – výsledky a komplikácie v dvojročnom sledovaní. Čes. a slov. Oftal., 71, 2015, No 3, p. 158-168.
  16. Kapitánová K, Žiak P. Vybrané ochorenia rohovky a ich vplyv na centrálnu zrakovú ostrosť. Health and soc. Work, 2018;13:4-14.
  17. Raiskup F, Theuring A, Pillunat LE , Spoerl E. Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results. J Cataract Refract Surg. 2015;41:41-46.
  18. Mahmoud AM, Roberts CJ, Lembach RG et al. CLMI The Cone Location and Magnitude Index. Cornea. 2008 May;27(4):480-487.
  19. Arce C, GALILEI: Map Interpretation Guide. Software V. Port. Switzerland: Ziemer Ophthalmic Systems AG;2011.
  20. Smadja D, Touboul D, Colin J. Comparative Evaluation of Elevation, Keratometric, Pachymetric and Wavefront Parameters in Normal Eyes, Subclinical Keratoconus and Keratoconus with a Dual Scheimpflug Analyzer. Int J Kerat Ect Cor Dis. 2012;1(3):158-166.
  21. Pjano MA, Biscevic A, Grisevic S, Gabric I, Salkica AS, Ziga N. Pachymetry and Elevation Back Map Changes in Keratoconus Patients After Crosslinking Procedure. Med Arch. 2020;74(2):105-108. doi:10.5455/medarh.2020.74.105-108
  22. Ambrósio R Jr, Alonso RS, Luz A, Coca Velarde LG. Corneal-thickness spatial profile and corneal-volume distribution: tomographic indices to detect keratoconus. J Cataract Refract Surg. 2006 Nov;32(11):1851-9. doi: 10.1016/j.jcrs.2006.06.025. PMID: 17081868
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