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Stromal lenticule addition keratoplasty with corneal crosslinking for corneal ectasia secondary to FS-LASIK:a case series

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International Journal of Ophthalmology(English edition) 2024年第3期17卷 596-602页

作者： Li-Xiang Wang Ying-Ping Deng Meng-Zhen Xie Ke Ma Hong-Bo Yin Qiong Wang Rui Gong Jing Tang Department of Ophthalmology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina West China School of Medicine Sichuan UniversityChengdu 610041Sichuan ProvinceChina

●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis(FS-LASIK).●METHODS:A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for *** lenticules were collected from patients undertaking small incision lenticule extraction(SMILE)for the correction of *** a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength.●RESULTS:All surgeries were conducted successfully with no significant *** best corrected visual acuity(BCVA)ranged from 0.05 to 0.8-2 before *** pre-operational total corneal thickness ranged from 345-404μm and maximum keratometry(Kmax)ranged from 50.8 to *** the combination surgery,both the corneal keratometry(range 55.9 to 92.8)and total corneal thickness(range 413-482μm)significantly *** out of 5 patients had improvement of corneal biomechanical parameters(reflected by stiffness parameter A1 in Corvis ST).However,3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient *** the onset of corneal edema right after SLAK,the corneal topography and thickness generally stabilized after 3mo.●CONCLUSION:SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal *** work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.

关键词： corneal ectasia femtosecond laserassisted in situ keratomileusis stromal lenticule addition keratoplasty corneal crosslinking corneal thickness corneal biomechanics

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Detecting early changes in choroidal vascularity and thickness using optical coherence tomography in patients with corneal crosslinking for keratoconus

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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1267-1272页

作者： Selim Doganay Mehmet Omer Kiristioglu Derya Doganay Elif Kacmaz Department of Ophthalmology Bursa Uludag University School of MedicineBursa 16059Turkey Department of Ophthalmology University of Health Sciences Bursa Yuksek Ihtisas Training and Research HospitalBursa 16310Turkey

AIM:To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal ***:This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal *** choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d,1,and *** thickness in the four cardinal quadrants and the fovea were *** choroidal vascularity index was also ***:There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d,1mo(P>0.05).There was a significant increase in the 3mo(P=0.034)and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d(P=0.014),there was no statistically significant change in vertical axes and other visits in horizontal sections(P>0.05).CONCLUSION:This study sheds light on choroidal changes in postoperative corneal crosslinking for *** it suggests the procedure’s relative safety for submacular choroid,more extensive research is necessary to confirm these findings and their clinical significance.

关键词： keratoconus corneal crosslinking choroidal vascularity index enhanced depth imaging optical coherence tomography

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Therapeutic and inducing effect of corneal crosslinking on infectious keratitis

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International Journal of Ophthalmology(English edition) 2016年第12期9卷 1820-1823页

作者： Liang-Zhu Jiang Shi-Yan Qiu Zhi-Wei Li Xiao Zhang Xiang-Chen Tao Guo-Ying Mu Department of Ophthalmology Shandong Provincial Hospital Affiliated to Shandong University Department of Ophthalmology the People's Hospital of Linyi Department of Pediatrics the People's Hospital of Linyi

The corneal crosslinking （CXL） with riboflavin and ultraviolet-A （UVA） is a new therapy method to successfully treat infectious keratitis in clinical practice. However, there are rare reports on the complications of CXL such as the secondary keratitis. The diverse clinical outcomes on keratitis have highlighted the necessity to further evaluate the efficacy and complications of CXL. We reviewed the positive and negative reports on UVA/riboflavin related with keratitis and provided our opinion on the therapeutic and side effect of UVA/riboflavin crosslinking on keratitis.

关键词： corneal crosslinking keratitis theraputic and inducing effect

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corneal collagen crosslinking in patients treated with dextran versus isotonic hydroxypropyl methylcellulose (HPMC) riboflavin solution: a retrospective analysis

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Eye and Vision 2018年第1期5卷 211-216页

作者： Patrick B.Rapuano Priya M.Mathews George J.Florakis Stephen L.Trokel Leejee H.Suh Department of Ophthalmology Edward S.Harkness Eye InstituteColumbia College of Physicians and Surgeons635 West 165th StreetNew YorkNY 10032USA

Background:corneal collagen crosslinking(CXL)is a widely used treatment for halting the progression of *** initial studies of CXL were performed with a riboflavin solution containing dextran,recent protocols for CXL have indicated the use of a riboflavin solution containing isotonic hydroxypropyl methylcellulose(HPMC).This study was performed to investigate differences in visual outcomes and Scheimpflug(Pentacam)analysis in patients who have undergone epithelium-off CXL with riboflavin solution containing either 20%dextran versus 1.1%***:All patients in this non-randomized,non-masked,retrospective cohort analysis were treated at Edward *** Eye Institute,Columbia University Medical Center,New York,NY,***-seven eyes of 33 patients were crosslinked with a dextran solution and 19 eyes of 19 patients crosslinked with an isotonic HPMC solution,both using an epithelium-off 30-min,3 mW/cm2 *** patients had a diagnosis of keratoconus or postrefractive surgery *** spectacle corrected visual acuity(BSCVA)and Pentacam parameters were compared at all follow up visits(1,6,12,and 24 months).Differences between groups treated with HPMC and dextran were compared using student’s *** between treated eye and fellow eye were calculated and compared between HPMC and dextran groups using paired ***:Patients treated with a dextran solution had significantly greater improvement in BSCVA at 1,6,and 24 months(pcrosslinking with the dextran solution may result in significantly better visual outcomes(demonstrated by visual acuity)compared to the isotonic HPMC ribof

关键词： corneal crosslinking Isotonic HPMC Dextran

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Iontophoresis-assisted versus standard corneal crosslinking for progressive keratoconus

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Annals of Eye Science 2017年第1期2卷 28-34页

作者： Hong-Zhen Jia Xu Pang Zheng-Jun Fan Xiu-Jun Peng Department of Ophthalmology Chinese PLA Navy General HospitalBeijing 100048China

Background:To compare the safety and efficacy of iontophoresis-assisted epithelial-on corneal crosslinking(I-CXL)using 0.1%riboflavin-distilled water solution with standard epithelium-off corneal crosslinking(S-CXL)for progressive ***:In a retrospective analysis,progressive keratoconus patients treated with I-CXL(17 eyes of 17 patients)or S-CXL(13 eyes of 13 patients)were *** patients were followed up at least 12 *** patients underwent detailed ophthalmologic examinations involving pre-and postoperative visual acuity,topographic parameters and ***-and postoperative complications were ***:No statistically significant differences were observed between the two groups at baseline with respect to visual acuity,age and thinnest corneal thickness(TCT).The postoperative decreases of K1 and Kmean in the S-CXL group represented statistically significantly better results than in the I-CXL group(t=2.093 and 2.123,P=0.046 and 0.043,respectively).Alterations of other parameters showed no significant differences between the two *** were no failure cases in the two ***:I-CXL using 0.1%riboflavin-distilled water solution provided effective treatment for progressive keratoconus at 12-month ***,the decreases of K1 and Kmean caused by I-CXL were less than those by *** treatment time,postoperative patient pain and risk of infection in I-CXL are all less than those in S-CXL,I-CXL is unable to completely replace S-CXL for progressive keratoconus temporarily.

关键词： Keratoconus corneal crosslinking iontophoresis riboflavin

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Identifying more reliable parameters for the detection of change during the follow-up of mild to moderate keratoconus patients

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Eye and Vision 2017年第1期4卷 143-149页

作者： Ivo Guber Colm McAlinden François Majo Ciara Bergin Department of Ophthalmology University of GenevaGenevaSwitzerland Department of Ophthalmology Glangwili HospitalHywel Dda University Health BoardCarmarthenUK School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Jules-Gonin Eye Hospital University of LausanneFondation Asile des AveuglesLausanneSwitzerland

Background:Reaching a consensus on which parameters are most reliable at detecting progressive keratoconus patients with serial topography imaging is not *** aim of the study was to isolate the parameters best positioned to detect keratoconus progression using the Pentacam HR^(®)measures based on the respective limits of repeatability and range of ***:Using the Pentacam HR^(®),a tolerance index was calculated on anterior segment parameters in healthy and keratoconic *** tolerance index provides a scale from least to most affected parameters in terms of measurement noise relative to that observed in healthy ***,based on the“number of increments”from no disease to advanced disease,a relative utility(RU)score was also *** values close to 1 indicate parameters best positioned to detect a change in keratoconic ***:The tolerance index values indicated that 36%of ocular parameters for keratoconic eyes had repeatability limits which were wider than normative limits(worse),but 28%of the ocular parameters were narrower than normative limits(better).Considering only those parameters with a RU greater than 0.95,a small number of parameters were within this range,such as corneal curvature and asphericity ***:This study demonstrates that measurement error in keratoconic eyes is significantly greater than healthy *** implemented here provide guidance on the levels of expected precision in keratoconic eyes relative to healthy eyes to aid clinicians in distinguishing real change from *** maximal keratometry(Kmax),central corneal thickness(CCT)and thinnest corneal thickness(TCT)were highlighted as problematic indices for the follow-up of keratoconus in terms of repeatability.

关键词： Pentacam Keratoconus Progression Repeatability Precision corneal crosslinking

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