Hatice Elvin YILDIZ, Züleyha YALNIZ AKKAYA, Firdevs ÖRNEK, Ayşe BURCU, Mehmet YAKIN

KERATOKONUSTA UYGULANAN KORNEA KOLLAJEN ÇAPRAZ BAĞ TEDAVİSİ SONUÇLARIMIZ

AMAÇ: Kliniğimizde keratokonus (KK) tanılı hastalarda uygulanan kornea kollajen çapraz bağ (KÇB) tedavisinin sonuçlarının değerlendirilmesi. HASTALAR VE YÖNTEM: Mayıs ve Ekim 2012 tarihleri arasında KK tanısı ile KÇB tedavisi uygulanmış 23 hastanın 30 gözü geriye dönük olarak incelendi. Tedavi öncesi ve tedavi sonrası 1, 3 ve 6. aylardaki düzeltilmemiş ve en iyi düzeltilmiş görme keskinlikleri, Pentacam ile elde edilen kornea topografileri, speküler mikroskopi ile elde edilen kornea endotel hücre sayıları incelendi. BULGULAR: On ikisi erkek, 11’i kadın hastanın yaşlarının ortanca değeri 18 (12-31) yıl idi. Düzeltilmemiş görme keskinliklerinde takiplerde işlem öncesine göre özellikle 3. ve 6. ayda artış olmasına rağmen fark anlamlı bulunmadı (P =0.738). Düzeltilmiş görme keskinliğinde 1. ayda düşüş görülmesine rağmen 3. ve 6. aydaki değerler işlem öncesi ile aynı düzeyde saptandı (P =0.528). Kornea dansitometre değerlerinde işlem öncesine kıyasla 1, 3 ve 6. aylarda anlamlı artış görüldü (sırasıyla P

OUTCOMES OF CORNEA COLLAGEN CROSS-LINKING IN THE MANAGEMENT OF KERATOCONUS

PURPOSE: To evaluate the results of cornea collagen cross-linking(CXL) in the management of keratoconus (KC).PATIENTS AND METHODS: The data of 30 eyes of 23 patientswho underwent CXL for the management of KC between Mayand October 2012 were reviewed retrospectively. Preoperativeand postoperative first, third and sixth month uncorrected andbest corrected visual acuities, corneal topographies by Pentacam,and corneal endothelial cell counts by specular microscopy wereevaluated.RESULTS: The median age of 12 male and 11 female patients was 18(12-31). Uncorrected visual acuity was increased at 3 and 6 monthsof follow-up but the difference was not statistically significant (P=0.738). The best corrected visual acuity was decreased one monthafter the procedure and increased to the preoperative values at 3 and6 months of follow up (P =0.528). Corneal densitometry value wasincreased significantly at 1, 3 and 6 months of follow up comparedto the preoperative value (P

PDF

___

1.)Espandar L, Meyer J. Keratoconus: overview and update on treatment. Middle East Afr J Ophthalmol. 2010;17:15-20.
2.)Or H. An Up-To-Date View at the Etiopathogenesis of Keratoconus. Turk J Ophthalmol. 2011;41:339-47.
3.)Spoerl E, Wollensak G, Seiler T. Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res. 2004;29:35-40.
4.)Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003;135:620-627.
5.)Caporossi A, Baiocchi S, Mazzotta C, Traversi C, Caporossi T. Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study. J Cataract Refract Surg. 2006;32:837-845.
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.)Wittig-Silva C, Whiting M, Lamoureux E, Lindsay RG, Sullivan LJ, Snibson GR. A randomized controlled trial of corneal collagen cross-linking in progressive keratoconus: preliminary results. J Refract Surg. 2008;24:720-725.
8.)Vinciguerra P, Albè E, Trazza S, et al. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology. 2009;116:369-378.
9.)Coskunseven E, Jankov MR 2nd, Hafezi F. Contralateral eye study of corneal collagen cross-linking with riboflavin and UVA irradiation in patients with keratoconus. J Refract Surg. 2009;25:371-376.
10.)Arbelaez MC, Sekito MB, Vidal C, Choudhury SR. Collagen cross-linking with riboflavin and ultraviolet-A light in keratoconus: One-year results. Oman J Ophthalmol. 2009;2:33-38.
11.)Hersh PS, Greenstein SA, Fry KL. Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. J Cataract Refract Surg. 2011;37:149-160.
12.)Gumus K, Mirza E, Erkilic K, et al. Preliminary Results of Cross-Linking with Riboflavin/UV-A in Patients with Progressive Keratoconus. Turk J Ophthalmol 2010;40:18-24.
13.)Wollensak G, Iomdina E, Dittert DD, Herbst H. Wound healing in the rabbit cornea after corneal collagen cross-linking with riboflavin and UVA. Cornea. 2007;26:600-605.
14.)Mazzotta C, Balestrazzi A, Traversi C, et al. Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans. Cornea. 2007;26:390-397.