Evaluation of Corneal Aberration Alterations After Accelerated Transepithelial Corneal Crosslinking

Objective: This study aimed to report the corneal aberration alterations after accelerated transepithelial corneal crosslinking (A-TE CXL) and to investigate the relationship between corrected distance visual acuity (CDVA) and corneal aberrations. Methods: Fifty-six eyes of 45 progressive keratoconus (KCN) patients who underwent A-TE CXL were retrospectively evaluated. Total ocular aberrations (TOA), high-order aberrations (HOA), low order aberrations (LOA), and spectacle-CDVA values were recorded preoperatively, 6, and 12 months after the procedure. The alterations of the parameters were compared and correlation analysis was performed between corneal aberrations and CDVA. Results: The mean age of the patients was 22.23±3.14 years. The preoperative, postoperative 6 and 12 months median CDVAs were 0.50 (0.20-0.90), 0.60 (0.20-1.0) and 0.60 (0.10-0.90), respectively. The preoperative root means square (RMS)-TOA, RMS-HOA, and RMS-LOA values were 2.4±0.88μm, 1.50±0.59μm, and 1.78±0.88μm, respectively. The CDVA values increased significantly at postoperative-6 month examinations. After the A-TE CXL procedure, the aberrations were detected as 2.58±0.94μm, 1.62±0.57μm, 1.90±0.99μm and 2.38±0.81μm, 1.46±0.57μm, 1.77±0.85μm at 6th and 12th months, respectively. The TOA and HOA values significantly decreased 6 and 12 months after A-TE CXL. The LOA alterations were not statistically significant. The correlation analysis between corneal aberrations and CDVA revealed no significance at any time point. Conclusion: Although the TOA and HOA values significantly decreased and CDVA significantly increased in the early postoperative period, a relationship between the CDVA and corneal aberration alterations was not detected. Even the corneal aberration improvement had contributed to the increase in CDVA, evaluation of epithelial structural alterations can be suggested to better understand the clinical outcomes.

Hızlandırılmış Transepitelyal Korneal Çapraz Bağlama Tedavisi Sonrası Korneal Aberasyon Değişimlerinin Değerlendirilmesi

Amaç: Bu çalışma hızlandırılmış transepitelyal korneal çapraz bağlama (H-TE KÇB) tedavisi sonrası korneal aberasyon değişimlerini sunmayı ve korneal aberasyonlar ile düzeltilmiş uzak görme keskinliği (DUGK) arasındaki ilişkiyi incelemeyi amaçladı. Yöntemler: H-TE KÇB tedavisi uygulanmış 45 progresif keratokonus (KKN) hastasının 56 gözü retrospektif olarak değerlendirildi. Total oküler aberasyonlar (TOA), yüksek sıralı aberasyonlar (YSA), düşük sıralı aberasyonlar (DSA) ve gözlükle DUGK değerleri işlem öncesinde ve 6-12 ay sonrasında kaydedildi. Bu parametrelerin değişimleri karşılaştırıldı ve DUGK ile korneal aberasyonlar arasında korelasyon analizi yapıldı. Bulgular: Hastaların ortalama yaşı 22.23±3.14 yıldı. Ameliyat öncesi, 6 ve 12 ay sonrası median DUGK değerleri sırasıyla 0.50 (0.20-0.90), 0.60 (0.20-1.0) and 0.60 (0.10-0.90) idi. Postoperatif 6.ay muayenesinde DUGK anlamlı olarak artmıştı. Ancak Ameliyat öncesi karekök (KK)-TOA, KK-YSA v e K K-DSA değerleri sırasıyla 2.4±0.88μm, 1.50±0.59μm and 1.78±0.88μm idi. Ameliyattan 6 ve 12 ay sonra ise bu değerler sırasıyla 2.58±0.94μm, 1.62±0.57μm, 1.90±0.99μm ve 2.38±0.81μm, 1.46±0.57μm, 1.77±0.85μm olarak saptandı. TOA ve YSA, H-TE KÇB tedavisi sonrası 6 ve 12. Ayda anlamlı olarak azaldı. DSA değişimleri ise anlamlı değildi.Hiçbir ölçüm zamanında korneal aberasyon değişimleri ile DUGK arasında anlamlı korelasyon saptanmadı. Sonuç: H-TE KÇB tedavisi sonrası TOA ve HOA değerlerinde anlamlı düşüş, DUGK’de erken postoperatif dönemde anlamlı bir artış olmasına rağmen bu değerler arasında bir ilişki saptanmadı. Tedavi sonrası DUGK artışına korneal aberasyonlardaki iyileşmenin katkısı olsa da, klinik sonuçları daha iyi anlamak için epitel yapısında meydana gelen değişimlerinde değerlendirilmesi önerilebilir.

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