Keratokonus hastalarında UVA-Riboflavin korneal kollajen çapraz bağlama tedavisinin sonuçları

Amaç: Bu çalışmada, keratokonus hastalarında korneal kollajen çapraz bağlama tedavisinin görme keskinliği ve merkezi kornea kalınlığına etkilerinin gösterilmesi amaçlanmıştır.Gereç ve Yöntem: Korneal kollajen çapraz bağlama işlemi uygulanan 26 hastanın 51 gözü çalışmaya dahil edildi. Merkezi kornea kalınlık ölçümleri ve en iyi düzeltilmiş görme keskinlikleri işlemden önce ve sonrasındaki 1. ay ve 6. ayda kayıt altına alındı.Bulgular: Ortalama merkezi kornea kalınlık ölçümleri işlem öncesi, işlem sonrası 1. ay ve işlem sonrası 6.ay olmak üzere sırasıyla 435,43±44,35μm, 376,68±66,55μm ve 392,62±64,21 μm olarak kaydedildi. İşlem öncesi ve işlem sonrası 1. ay, işlem öncesi ve işlem sonrası 6.ay ve işlem sonrası 1. ay ve işlem sonrası 6.ay merkezi kornea kalınlığı ölçümleri arasında istatistiksel olarak anlamlı fark bulundu. Aynı zamanda,  işlem sonrası görme keskinliği artışı istatistiksel olarak anlamlı bulundu.Sonuç: İşlem öncesi, işlem sonrası 1.ay ve işlem sonrası 6. ay merkezi kornea kalınlık ölçümleri ve en iyi düzeltilmiş görme keskinliği ölçümlerinde istatistiksel olarak anlamlı değişiklikler bulundu.

Outcome of UVA-Riboflavin collagen cross-linking of cornea in patients with keratoconus

Purpose: In this study, we aimed to show changes of central corneal thickness and effects of treatment on visual acuity after corneal collagen cross-linking in keratoconus patients.

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  • 1. Espandar L, Meyer J. Keratoconus: overview and update on treatment. Middle East Afr J Ophthalmol. 2010;17:15-20.
  • 2. Edwards M, McGhee C.N, Dean S. The genetics of keratoconus. Clin Exp Ophthalmol. 2001;29:345-51.
  • 3. Smith VA, Hoh HB, Littleton M, Easty DL. Over-expression of a gelatinase A activity in keratoconus. Eye (Lond). 1995;9:429-33.
  • 4. Smith VA, Easty DL. Matrix metalloproteinase 2: involvement in keratoconus. Eur J Ophthalmol. 2000;10:215-26. 5. Parkin BT, Smith VA, Easty DL. The control of matrix metalloproteinase-2 expression in normal and keratoconic corneal keratocyte cultures. Eur J Ophthalmol. 2000;10:276-85.
  • 6. Ku JY, Niederer RL, Patel DV, Sherwin T, McGhee CN. Laser scanning in vivo confocal analysis of keratocyte density in keratoconus. Ophthalmology. 2008;115:845-50.
  • 7. Rabinowitz YS. Keratoconus. Surv Ophthalmol. 1998;42:297-319.
  • 8. Barnett M, Mannis MJ. Contact lenses in the management of keratoconus. Cornea. 2011;30:1510-6.
  • 9. Dahl BJ, Spotts E, Truong JQ. Corneal collagen cross-linking: An introduction and literature review. Optometry. 2012;83:33-42.
  • 10. Arne JL, Fournié P. Keratoconus, the most common corneal dystrophy. Can keratoplasty be avoided? Bull Acad Natl Med. 2011;195:113-29.
  • 11. Touboul D, Trichet E, Binder PS, Praud D, Seguy C, Colin J. Comparison of front-surface corneal topography and Bowman membrane specular topography in keratoconus. J Cataract Refract Surg. 2012;38:1043-9.
  • 12. Kling S, Ginis H, Marcos S. Corneal Biomechanical Properties from Two-Dimensional Corneal Flap Extensiometry: Application to UV-Riboflavin Cross-Linking. Invest Ophthalmol Vis Sci. 2012;53:5010-5.
  • 13. Hafezi F, Mrochen M, Iseli HP, Seiler T. Collagen crosslinking with ultraviolet-A and hypoosmolar riboflavin solution in thin corneas. J Cataract Refract Surg. 2009;35:621-4.
  • 14. Bottós KM, Schor P, Dreyfuss JL, Nader HB, Chamon W. Effect of corneal epithelium on ultraviolet-A and riboflavin absorption. Arq Bras Oftalmol. 2011;74:348-51.
  • 15. Wollensak G. Crosslinking treatment of progressive keratoconus. Ophthalmology: new hope. Curr Opin Ophthalmol. 2006;17:356-60.
  • 16. Coskunseven E, Jankov MR, Hafezi F. Contralateral eye study of cornealcollagen cross-linking with riboflavin and UVA irradiation in patients with keratoconus. J Refract Surg. 2009;25:371-6.
  • 17. Spoerl E, Huhle M, Seiler T. Induction of crosslinks in corneal tissue. Exp Eye Res. 1998;66:97-103.
  • 18. Wollensak G, Spoerl E, Wilsch M, Seiler T. Endothelial cell damage after riboflavinultraviolet- A treatment in the rabbit. J Cataract Refract Surg. 2003;29:1786-90.
  • 19. Kohlhaas M, Spoerl E, Schilde T, Unger G, Wittig C, Pillunat LE. Biomechanical evidence of the distribution of cross-links in corneas treated with riboflavin and ultraviolet A light. J Cataract Refract Surg. 2006;32:279-83.
  • 20. Wollensak G, Spoerl E, Wilsch M, Seiler T. Keratocyte apoptosis after corneal collagen cross-linking using riboflavin/UVA treatment. Cornea. 2004;23:43-9.
  • 21. Seiler T, Hafezi F. Corneal cross-linking-induced stromal demarcation line. Cornea. 2006;25:1057-9.
  • 22. Gumuş K, Mirza E, Erkılıc K, Arda H, Öner A, Dağ S et al. İlerleyici tip keratokonus hastalarında riboflavin/UV-A ile çapraz bağlama tedavisinin erken dönem sonuçları. Turk J Ophthalmol. 2010;40:18-24.
  • 23. 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;32:837-45.
  • 24. 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;149:585-93.
  • 25. Raiskup-Wolf F, Hoyer A, Spoerl E, Pillunat LE. Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: longterm results. J Cataract Refract Surg. 2008;34:796-801.
  • 26. Vinciguerra P, Albe E, Trazza S, Rosetta P, Vinciguerra R, Seiler T et al. Refractive, topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking. Ophthalmology. 2009;116:369-78.
  • 27. Grewal DS, Brar GS, Jain R, Sood V, Singla M, Grewal SPS. Corneal collagen crosslinking using riboflavin and ultraviolet-Alight for keratoconus; one-year analysis using Scheimpflug imaging. J Cataract Refract Surg. 2009;35:425-32.
  • 28. Greenstein A, Shah VP, Fry KL. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results. J Cataract Refract Surg. 2011;37:691-700.
  • 29. Koller T, İseli HP, Hafezi F. Scheimpflug imaging of corneas after collagen crosslinking. Cornea. 2009;28:510-5.
  • 30. Mazzotta C, Traversi C, Baiocchi S, Caporossi O, Bovone C, Sparano MC, Balestrazzi A, Caporossi A. Corneal healing after riboflavin ultraviolet-A collagen cross-linking determined by confocal laser scanning microscopy in vivo: early and late modifications. Am J Ophthalmol. 2008;146:527-33.
  • 31. Bottos KM, Dreyfuss JL, Regatieri CV, Lima-Filho AA, Schor P, Nader HB et al. Immunofluorescence confocal microscopy of porcine corneas following collagen cross-linking treatment with riboflavin and ultraviolet A. J Refract Surg. 2008; 24:715-9.
  • 32. Wollensak G, Aurich H, Pham D-T, Wirbelauer C. Hydration behavior of porcine cornea crosslinked with riboflavin and ultraviolet A. J Cataract Refract Surg. 2007;33:516-21.
  • 33. Raiskup F, Spoerl E. Corneal crosslinking with riboflavin and ultraviolet A.I. Principles. Ocul Surf. 2013;11:65-74.
  • 34. Witta-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;24:720-5.
Cukurova Medical Journal-Cover
  • ISSN: 2602-3032
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1976
  • Yayıncı: Çukurova Üniversitesi Tıp Fakültesi