Journal francais d'ophtalmologie · 2021
Poor re-epithelialization following corneal collagen crosslinking with riboflavin-uva for advanced bullous keratopathy: Case series.
СтатьяНазвание и аннотация: Перевод в очереди
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Arriola-Villalobos P, Benito-Pascual B, Ariño-Gutiérrez M, Iradier-Urrutia M T
Аннотация
OBJECTIVE: To assess safety and efficacy of corneal collagen crosslinking (CXL) for advanced bullous keratopathy (BK).
MATERIAL AND METHODS: Eight eyes of eight patients subjected to Dresden CXL protocol.
INCLUSION CRITERIA: BK history of at least one year, severe pain and no indication for keratoplasty due to poor visual prognosis.
VARIABLES: best corrected visual acuity (BCVA), pain (decimal visual scale), central corneal thickness (CCT) by tomography (Pentacam®, Oculus Inc, Germany), corneal bullae and complications.
RESULTS: Seven women and one man of median age 77.00 (range 58-79) years. The median follow-up was 7 (range 5-7) months. BCVA remained unchanged through follow-up. A significant decrease in pain was observed at the end of the follow-up period (median 6, range 5-6 vs. median 0, range 0-4, P=0.05). Corneal tomography could only be performed in three cases, due to poor vision or image quality. A reduction in mean CCT was observed in the first post procedural month (from 708.33±140.48 to 627±136.89μm). In all eight cases, the absence of corneal bullae only persisted for two months after CXL. In six patients, corneal re-epithelialization after CXL was poor; in four of these eyes, the problem was resolved with topical treatment, but in the remaining two eyes, amniotic membrane transplant and mechanical debridement were required.
CONCLUSIONS: In this uncontrolled small case series, CXL treatment improved pain in patients with advanced BK. However, the high rate of poor re-epithelialization requiring surgical treatment observed in one third of cases makes this treatment controversial.
MATERIAL AND METHODS: Eight eyes of eight patients subjected to Dresden CXL protocol.
INCLUSION CRITERIA: BK history of at least one year, severe pain and no indication for keratoplasty due to poor visual prognosis.
VARIABLES: best corrected visual acuity (BCVA), pain (decimal visual scale), central corneal thickness (CCT) by tomography (Pentacam®, Oculus Inc, Germany), corneal bullae and complications.
RESULTS: Seven women and one man of median age 77.00 (range 58-79) years. The median follow-up was 7 (range 5-7) months. BCVA remained unchanged through follow-up. A significant decrease in pain was observed at the end of the follow-up period (median 6, range 5-6 vs. median 0, range 0-4, P=0.05). Corneal tomography could only be performed in three cases, due to poor vision or image quality. A reduction in mean CCT was observed in the first post procedural month (from 708.33±140.48 to 627±136.89μm). In all eight cases, the absence of corneal bullae only persisted for two months after CXL. In six patients, corneal re-epithelialization after CXL was poor; in four of these eyes, the problem was resolved with topical treatment, but in the remaining two eyes, amniotic membrane transplant and mechanical debridement were required.
CONCLUSIONS: In this uncontrolled small case series, CXL treatment improved pain in patients with advanced BK. However, the high rate of poor re-epithelialization requiring surgical treatment observed in one third of cases makes this treatment controversial.