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| Efficacy and Safety of Phototherapeutic Keratectomy and Corneal Collagen cross-Linking combined Therapy on Primary Keratoconus |
| Jia Zhang,Chang Liu,Yini Li,Ping Ding,Pei Wen,Chunmeng Wang,Yaru Zheng,Qinmei Wang,Shihao Chen |
| Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China |
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Abstract Objective: To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) and corneal collagen cross-linking (CXL) combined therapy on primary keratoconus. Methods: In this prospective,self-controlled clinical study, 11 patients (11 eyes) underwent treatment with combined PTK and CXL.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, topography,corneal thickness, and endothelial cell density were evaluated preoperatively and at 12 months postoperatively. Data were analyzed using paired t-tests. results: At 12 months postoperatively, UCVA,sphere, and spherical equivalent improved significantly (t=3.692, P=0.008; t=-1.397, P=0.039; t=-2.363,P=0.040 respectively). Maximum K-value (Kmax) and corneal thinnest thickness decreased significantly
(t=2.941, P=0.007; t=3.839; P=0.003). There were no significant changes in endothelial cell density (t=-1.615, P=0.172). conclusions: PTK and CXL combined therapy was effective and safe in the treatment of progressive primary keratoconus.
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Received: 15 August 2017
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Corresponding Authors:
Shihao Chen, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China(Email: chenle@rocketmail.com)
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| [1] |
Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol, 2003, 135(5): 620-627.
|
| [2] |
Reinstein DZ, Gobbe M, Archer TJ, et al. Epithelial, stromal, and total corneal thickness in keratoconus: three-dimensional display with artemis very-high frequency digital ultrasound. J Refract Surg, 2010, 26(4): 259-271. DOI: 10.3928/1081597X-20100218-01.
|
| [1] |
Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol, 2003, 135(5): 620-627.
|
| [2] |
Reinstein DZ, Gobbe M, Archer TJ, et al. Epithelial, stromal, and total corneal thickness in keratoconus: three-dimensional display with artemis very-high frequency digital ultrasound. J Refract Surg, 2010, 26(4): 259-271. DOI: 10.3928/1081597X-20100218-01.
|
| [3] |
Haque S, Simpson T, Jones L. Corneal and epithelial thickness in keratoconus: a comparison of ultrasonic pachymetry, Orbscan II,and optical coherence tomography. J Refract Surg, 2006, 22(5):486-493.
|
| [3] |
Haque S, Simpson T, Jones L. Corneal and epithelial thickness in keratoconus: a comparison of ultrasonic pachymetry, Orbscan II,and optical coherence tomography. J Refract Surg, 2006, 22(5):486-493.
|
| [4] |
彭梅, 胡磾, 姬戎媛, 等. 超高分辨率OCT测量角膜上皮层厚度在圆锥角膜诊断中的价值. 中华眼视光学与视觉科学杂志,2015, 17(1): 9-13.
|
| [4] |
彭梅, 胡磾, 姬戎媛, 等. 超高分辨率OCT测量角膜上皮层厚度在圆锥角膜诊断中的价值. 中华眼视光学与视觉科学杂志,2015, 17(1): 9-13.
|
| [5] |
Scroggs MW, Proia AD. Histopathological variation in keratoconus. Cornea, 1992, 11(6): 553-559.
|
| [6] |
Caporossi A, Mazzotta C, Paradiso AL, et al. Transepithelial corneal collagen crosslinking for progressive keratoconus:24-month clinical results. J Cataract Refract Surg, 2013, 39(8):1157-1163. DOI: 10.1016/j.jcrs.2013.03.026.
|
| [7] |
Kocak I, Aydin A, Kaya F, et al. Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus. J Fr Ophtalmol, 2014, 37(5): 371-376.DOI: 10.1016/j.jfo.2013.11.012.
|
| [8] |
Leccisotti A, Islam T. Transepithelial corneal collagen cross-linking in keratoconus. J Refract Surg, 2010, 26(12): 942-948.DOI: 10.3928/1081597X-20100212-09.
|
| [9] |
Buzzonetti L, Petrocelli G. Transepithelial corneal cross-linking in pediatric patients: early results. J Refract Surg, 2012, 28(11):763-767. DOI: 10.3928/1081597X-20121011-03.
|
| [5] |
Scroggs MW, Proia AD. Histopathological variation in keratoconus. Cornea, 1992, 11(6): 553-559.
|
| [6] |
Caporossi A, Mazzotta C, Paradiso AL, et al. Transepithelial corneal collagen crosslinking for progressive keratoconus:24-month clinical results. J Cataract Refract Surg, 2013, 39(8):1157-1163. DOI: 10.1016/j.jcrs.2013.03.026.
|
| [7] |
Kocak I, Aydin A, Kaya F, et al. Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus. J Fr Ophtalmol, 2014, 37(5): 371-376.DOI: 10.1016/j.jfo.2013.11.012.
|
| [8] |
Leccisotti A, Islam T. Transepithelial corneal collagen cross-linking in keratoconus. J Refract Surg, 2010, 26(12): 942-948.DOI: 10.3928/1081597X-20100212-09.
|
| [9] |
Buzzonetti L, Petrocelli G. Transepithelial corneal cross-linking in pediatric patients: early results. J Refract Surg, 2012, 28(11):763-767. DOI: 10.3928/1081597X-20121011-03.
|
| [10] |
Koppen C, Wouters K, Mathysen D, et al. Refractive and topographic results of benzalkonium chloride-assisted transepithelial crosslinking. J Cataract Refract Surg, 2012,
|
| 38 |
(6): 1000-1005. DOI: 10.1016/j.jcrs.2012.01.024.
|
| [10] |
Koppen C, Wouters K, Mathysen D, et al. Refractive and topographic results of benzalkonium chloride-assisted transepithelial crosslinking. J Cataract Refract Surg, 2012,
|
| 38 |
(6): 1000-1005. DOI: 10.1016/j.jcrs.2012.01.024.
|
| [11] |
Kolozsvári L, Nógrádi A, Hopp B, et al. UV absorbance of the human cornea in the 240- to 400-nm range. Invest Ophthalmol Vis Sci, 2002, 43(7): 2165-2168.
|
| [11] |
Kolozsvári L, Nógrádi A, Hopp B, et al. UV absorbance of the human cornea in the 240- to 400-nm range. Invest Ophthalmol Vis Sci, 2002, 43(7): 2165-2168.
|
| [12] |
Kymionis GD, Grentzelos MA, Karavitaki AE, et al.Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-
|
|
Linking with Riboflavin and UVA Irradiation. J Ophthalmol,2010, 2010: 146543. DOI: 10.1155/2010/146543.
|
| [13] |
Kymionis GD, Grentzelos MA, Kankariya VP, et al. Long-term results of combined transepithelial phototherapeutic keratectomy and corneal collagen crosslinking for keratoconus: Cretan protocol. J Cataract Refract Surg, 2014, 40(9): 1439-1445. DOI:10.1016/j.jcrs.2014.01.040.
|
| [12] |
Kymionis GD, Grentzelos MA, Karavitaki AE, et al.Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-
|
|
Linking with Riboflavin and UVA Irradiation. J Ophthalmol,2010, 2010: 146543. DOI: 10.1155/2010/146543.
|
| [13] |
Kymionis GD, Grentzelos MA, Kankariya VP, et al. Long-term results of combined transepithelial phototherapeutic keratectomy and corneal collagen crosslinking for keratoconus: Cretan protocol. J Cataract Refract Surg, 2014, 40(9): 1439-1445. DOI:10.1016/j.jcrs.2014.01.040.
|
| [14] |
Kapasi M, Baath J, Mintsioulis G, et al. Phototherapeutic keratectomy versus mechanical epithelial removal followed by corneal collagen crosslinking for keratoconus. Can
|
|
J Ophthalmol, 2012, 47(4): 344-347. DOI: 10.1016/j.jcjo.2012.03.046.
|
| [14] |
Kapasi M, Baath J, Mintsioulis G, et al. Phototherapeutic keratectomy versus mechanical epithelial removal followed by corneal collagen crosslinking for keratoconus. Can
|
|
J Ophthalmol, 2012, 47(4): 344-347. DOI: 10.1016/j.jcjo.2012.03.046.
|
| [15] |
Kymionis GD, Grentzelos MA, Kounis GA, et al. Combined transepithelial phototherapeutic keratectomy and corneal collagen cross-linking for progressive keratoconus.
|
|
Ophthalmology, 2012, 119(9): 1777-1784. DOI: 10.1016/j.ophtha.2012.03.038.
|
| [16] |
Gaster RN, Ben Margines J, Gaster DN, et al. Comparison of the effect of epithelial removal by transepithelial phototherapeutic keratectomy or manual debridement on cross-linking proceduresfor progressive keratoconus. J Refract Surg, 2016, 32(10): 699-704. DOI: 10.3928/1081597X-20160712-01.
|
| [15] |
Kymionis GD, Grentzelos MA, Kounis GA, et al. Combined transepithelial phototherapeutic keratectomy and corneal collagen cross-linking for progressive keratoconus.
|
|
Ophthalmology, 2012, 119(9): 1777-1784. DOI: 10.1016/j.ophtha.2012.03.038.
|
| [16] |
Gaster RN, Ben Margines J, Gaster DN, et al. Comparison of the effect of epithelial removal by transepithelial phototherapeutic keratectomy or manual debridement on cross-linking proceduresfor progressive keratoconus. J Refract Surg, 2016, 32(10): 699-704. DOI: 10.3928/1081597X-20160712-01.
|
|
|
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