Original articleLong-term Results of Riboflavin Ultraviolet A Corneal Collagen Cross-linking for Keratoconus in Italy: The Siena Eye Cross Study
Section snippets
Methods
To date, 363 eyes with progressive keratoconus have been treated in Siena with the riboflavin UV A corneal collagen cross-linking procedure. The Siena Eye Cross Study9, 10 (phase II nonrandomized open trial) included 44 patients with keratoconus between 10 and 40 years of age with disease progression documented clinically and instrumentally in the last 6 months, minimum corneal thickness of 400 μm in the thinnest point evaluated by Orbscan IIz (Bausch & Lomb, Inc., Rochester, New York, USA),
Results
The mean preoperative pachymetric value measured by central US pachymetry was 450 ± 14.54 μm (range, 422 to 512 μm) and that by optical Orbscan IIz system in the thinnest point was of 438 ± 13.87 μm (range, 408 to 503 μm). During follow-up, the Orbscan II z measurement showed significant underestimation of corneal thickness compared with US and confocal microscopic pachymetric examinations, with a mean of −120 μm in the first 6 months and −70 μm between 6 and 12 months. US and confocal
Discussion
Riboflavin UV A corneal collagen cross-linking currently represents the only pathogenetic approach to progressive keratoconus to delay its progression6, 9, 10 and to reduce the need for donor keratoplasty. The long-term results recorded in the Siena Eye Cross Study confirm another encouraging long-term report in the literature11 and our pilot study9 on riboflavin UV A-induced corneal collagen cross-linking, as far as safety and effectiveness are concerned.12 Analyzing the results, an important
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Corneal biomechanical stiffness and histopathological changes after in vivo repeated accelerated corneal cross-linking in cat eyes
2023, Experimental Eye ResearchCitation Excerpt :A-CXL has a shorter exposure time and showed comparable results in halting keratoconus progression when compared with traditional CXL (Amer et al., 2020; Shajari et al., 2019; Waszczykowska and Jurowski, 2015). Although studies have shown the effectiveness of CXL with high success rates (Caporossi et al., 2010; Hashemi et al., 2013; Kymionis et al., 2014a; O'Brart et al., 2015), deterioration after CXL was reported in some cases, along with steepening of keratometric values, increase in irregular astigmatism, or decrease in corneal thickness. During the 1–6 years of follow-up, the progression rate after initial CXL treatment and after initial traditional epi-off treatment was up to 11% (Gore et al., 2021; Koller et al., 2009; Lenk et al., 2021; Poli et al., 2015), whereas that for epi-on CXL was as high as 23% at 1-year follow-up (Soeters et al., 2015).
Accelerated corneal crosslinking with 20′-soaking hydroxypropyl methyl cellulose/riboflavin vs conventional crosslinking with 30′-soaking dextran/riboflavin
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