İlerleyici Keratokonus Olgularında Riboflavin/UV-A ile Korneal Çapraz Bağlama Tedavisinin Sonuçları

Amaç: Keratokonus kliniğinde ilerleme saptanan olgular- da, UV-A/riboflavin ile korneal kollajen çapraz bağlama yönteminin sonuçlarının değerlendirilmesi. Yöntemler: İlerleyici keratokonusu olan 30 olgunun (16 kadın, 14 erkek) 47 gözü çalışmaya dahil edildi. Tüm ol- guların uygulama öncesi ve sonrasında, düzeltilmemiş ve düzeltilmiş en iyi görme keskinleri, biyomikroskopik bul- guları, göz içi basınç ölçümleri, fundus bulguları, pakimet- ri değerleri ve kornea topografi parametreleri kaydedildi. Bulgular: Olguların ortalama yaşı 18,3 yıl (8-31) ve orta- lama takip süresi 7±2,4 ay (3-12) idi. Uygulama sonrasın- daki takipler sonucunda ortalama K1, K2, Kav, sferik ve silindirik değerlerde sırasıyla; 0,77 diyoptri (D), 0,85 D, 0,80 D, 0,50 D ve 0,74 D azalma saptandı (p

The Results of Cross-Linking With Riboflavin/UV-A in Patients With Progressive Keratoconus

Objective: To evaluate the results of corneal cross-link- ing with UV-A/riboflavin in patients with progressive kera- toconus. Methods: Forty-seven eyes of 30 patients with progres- sive keratoconus (16 female, 14 male) were included in the study. Uncorrected and the best corrected distance visual acuities, biomicroscopic findings, intraocular pres- sure measurements, fundoscopic findings, pachymetric measurements and corneal topography parameters were recorded for each patient. Results: The mean age of the patients was 18.3±5.34 (range: 8-31) years and the mean follow-up duration was 7±2.4 (range: 3-12) months. Following the procedure, the mean decrease in K1, K2, Kav, spherical and cylindri- cal values were 0.77 D, 0.85 D, 0.80 D, 0.50 D and 0.74 D, respectively (p<0.05). There were no cases with de- crease in visual acuity and significant complication during or after the treatment. Conclusion: Cross-linking with riboflavin/UV-A in patients with progressive keratoconus is an effective procedure. In addition, the preservation of visual acuity and not seen a significant complication indicate that a safe metod. How- ever, large prospective randomized controlled studies are needed to evaluate the long-term effects of this treatment.

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  • 1. Kennedy RH, Bourne WM, Dyer JA. A 48-year clinical and epidemiologic study of keratoconus. Am J Ophthalmol 1986;101:267-273. 2. Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998;42:297- 319. 3. Krachmer JH, Feder RS, Belin MW. Keratoconus and related non-inflammatory corneal thinning disorders. Surv Oph- thalmol 1984;28:293-322. 4. Wollensak G. Crosslinking treatment of progressive kerato- conus: new hope. Curr Opin Ophthalmol 2006;17:356-360. 5. Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a- induced collagen crosslinking for the treatment of kerato- conus. Am J Ophthalmol. 2003;135:620-627. 6. Spoerl E, Mrochen M, Sliney D, et al. Safety of UVA ribofla- vin cross-linking of the cornea. Cornea 2007;26:385-389. 7. Wollensak G, Wilsch M, Spoerl E, Seiler T. Collagen fiber diameter in the rabbit cornea after collagen crosslinking by riboflavin/UVA. Cornea 2004;23:503-507. 8. Agrawal VB. Corneal collagen cross-linking with riboflavin and ultraviolet - a light for keratoconus: results in Indian eyes. Indian J Ophthalmol. 2009;57:111-114. 9. Grewal DS, Brar GS, Jain R, et al. Corneal collagen cross- linking using riboflavin and ultraviolet-A light for kera- toconus: one-year analysis using Scheimpflug imaging. J Cataract Refract Surg 2009;35:425-432. 10. Caporossi A, Baiocchi S, Mazzotta C, et al. Parasurgical therapy for keratoconus byriboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary re- fractive results in an Italian study. J Cataract Refract Surg 2006;32:837-845. 11. Derakhshan A, Shandiz JH, Ahadi M, et al. Short-term outcomes of collagen crosslinking for early keratoconus. J Ophthalmic Vis Res 2011;6:155-159. 12. Gümüş K, Mirza E, Erkılıç K. ve ark. İlerleyici tip kerato- konus olgularinda riboflavin/UV-A ile çapraz bağlama teda- visinin erken dönem sonuçlari. TOD Derg 2010;40:18-24. 13. Raiskup-Wolf F, Hoyer A, Spoerl E, Pillunat LE. Colla- gen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results. J Cataract Refract Surg 2008;34:796-801. 14. Coşkunseven E, Jankov MR, 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. 15. 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;149:585-593. 16. Mazzotta C, Balestrazzi A, Traversi C. et al. Treatment of progressive keratoconus by riboflavin-UVA-induced cross- linking of corneal collagen.Ultrastructural analysis by Hei- delberg Retinal Tomography II invivo confocal microscopy in humans. Cornea 2007;26:390-397. 17. Kymionis GD, Diakonis VF, Kalyvianaki M. et al. One- year follow-up of corneal confocal microscopy after cor- neal cross-linking in patients with post laser in situ kera- tosmileusis ectasia and keratoconus. Am J Ophthalmol 2009;147:774-778.
Dicle Tıp Dergisi-Cover
  • ISSN: 1300-2945
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1963
  • Yayıncı: Cahfer GÜLOĞLU
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