Accelerated Versus Conventional Corneal Collagen Cross-Linking in the Treatment of Keratoconus: A Meta-analysis and Review of the Literature

AbstractAimOur aim was to examine existing literature, and determine if there are outcome differences between accelerated corneal collagen cross-linking (A-CXL) and conventional corneal collagen cross-linking (C-CXL).MethodsA systematic review of the literature was conducted examining studies which compared A-CXL to C-CXL. Available studies were combined and the weighted mean difference (WMD) was calculated for range of outcome measures including maximal keratometry (Kmax), mean keratometry (Kmean) and minimum keratometry (Kmin), spherical equivalent, best corrected visual acuity (BCVA), and central corneal thickness (CCT).ResultsSeven eligible studies were included in our meta-analysis, with 283 eyes (135 in A-CXLand 148 in C-CXL). In the combined analysis, there was no statistically significant difference observed inKmin orKmax between A-CXL and C-CXL for at least 6  months after the procedure.Kmean was statistically higher in the C-CXL group in comparison with the A-CXL group for at least 6  months after the procedure (WMD − 3.15, 95% CI − 4.34 to − 1.97,p 
Source: Interdisciplinary Sciences, Computational Life Sciences - Category: Bioinformatics Source Type: research

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CONCLUSIONS: ATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up. PMID: 32051139 [PubMed - as supplied by publisher]
Source: The British Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Br J Ophthalmol Source Type: research
Authors: Gutierrez-Bonet R, Ruiz-Medrano J, Biarnés M, Rasheed MA, Vupparaboina KK, Chhablani J, Ruiz-Moreno JM Abstract Purpose: To analyse the vascular density of the choroid in a keratoconus (KC) population using swept-source optical coherence tomography (SS-OCT). Methods: Prospective, noninterventional study that analysed 97 eyes from 52 KC patients and 145 eyes from 89 healthy controls. The sample was divided in four different age groups. Inclusion criteria were topographic diagnosis of KC using Pentacam, axial length shorter than 26 mm, good quality of the images, and no other systemic or oc...
Source: Journal of Ophthalmology - Category: Opthalmology Tags: J Ophthalmol Source Type: research
Conclusions: Graft flattening during the early postoperative period and prolonged time interval from surgery to initial suture removal might be factors predisposing to the development of PGHSO. This complication did not affect postoperative visual outcomes when the central 4-mm area of the graft remained clear.
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research
Conclusions: The “doughnut pattern” of epithelial remodeling in keratoconus is supported by Scheimpflug imaging. This pattern is demonstrated to partially compensate for central corneal steepening seen in keratoconus.
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research
Purpose: The aim of this study was to evaluate the psychometric properties of the Keratoconus Outcomes Research Questionnaire (KORQ) in patients enrolled in the Save Sight Keratoconus Registry. Methods: A cross-sectional study was conducted utilizing prospectively collected web-based registry data. The psychometric properties of the KORQ were assessed using both classical test theory and Rasch analysis. Andrich group rating scale variant of the Rasch analysis was conducted using Winsteps software, Version 3.92.1. Results: The KORQ was completed by 189 patients with keratoconus (men, 67.7%; white, 69.8%; median age ...
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research
Conclusions: CXL may cause permanent keratocyte loss or repopulation of altered keratocytes, resulting in clinical complications such as corneal opacification or perforation. Despite its good safety profile and high effectiveness in progressive keratoconus, CXL should be performed in accordance with current guidelines strictly adhering to protocol and safety standards.
Source: Cornea - Category: Opthalmology Tags: Basic Investigation Source Type: research
Purpose: To investigate the association of systemic diseases with keratoconus in the general Korean population. Methods: This is a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015, involving 1,108,369 individuals. Patients with keratoconus were identified using the Korean standard classification of diseases code H18.6. The prevalence and annual incidence rates were estimated. To examine the risk factors, 5 controls were matched per patient with keratoconus by propensity score matching using age and household inco...
Source: Cornea - Category: Opthalmology Tags: Basic Investigation Source Type: research
Conclusions: There is a need for a comprehensive and high-quality patient-reported outcome measure in keratoconus. A questionnaire should be chosen based on the purpose and the quality of the questionnaire. This review guides selection of an appropriate questionnaire.
Source: Cornea - Category: Opthalmology Tags: Review Source Type: research
ConclusionCareful clinical judgement guided by corneal topography are needed for proper the diagnosis of acquired corneal opacification that results in reduction of vision to identify ACSH from other similar conditions (PHSCD and SND). Peeling of the thickened epithelial and sub-epithelial tissue is curative avoiding the need for corneal re-grafting.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This case-control, genome-wide association study assesses genetic susceptibility regions for keratoconus via a genome-wide association study of a discovery cohort and 3 independent replication cohorts from the United States, Northern Ireland, and Australia.
Source: JAMA Ophthalmology - Category: Opthalmology Source Type: research
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