Journal of cataract and refractive surgery · 2026
Comparison of epithelium-on customized remodeled vision and epithelium-off accelerated crosslinking in keratoconus treatment: 2-year study.
СтатьяНаблюдательное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Halašová Zuzana, Stodůlka Pavel, Škrovinová Lucia, Rakušanová Simona, Slovák Martin, Randárová Eva
Аннотация
PURPOSE: To evaluate the effectiveness and safety of epithelium-on (epi-on) customized remodeled vision (CuRV) crosslinking compared with epithelium-off (epi-off) accelerated corneal crosslinking (aCXL) in stabilizing keratoconus and improving visual outcomes.
SETTING: Gemini Eye Clinic, Zlín, Czech Republic.
DESIGN: Prospective, observational, nonrandomized 1-center study.
METHODS: The study included 179 eyes (135 patients) with progressive keratoconus (grades 1 to 3-4). Patients received either epi-on CuRV (n = 77 eyes) or epi-off aCXL (n = 102 eyes) and were followed for 24 months. Distance visual acuities, refraction, maximum keratometry (Kmax), corneal thickness, wavefront aberrations, endothelial cell count, and adverse events were assessed.
RESULTS: CuRV demonstrated greater and sustained reductions in Kmax (-2.46 ± 2.64 diopters [D] vs -1.38 ± 2.13 D, P = .0018) and mean keratometry (-0.93 ± 1.62 D vs -0.52 ± 1.02 D, P = .0367) compared with aCXL over 2 years. CuRV resulted in a lower rate of Kmax increase (>1 D) compared with aCXL (1% vs 9%). Higher-order aberrations improved significantly in both groups, with greater overall reduction in the CuRV group.
CONCLUSIONS: The CuRV protocol, using topography-guided, pulsed UV-A exposure with oxygenation, effectively stabilizes keratoconus while improving corneal shape and reducing aberrations. Its noninvasive, epi-on approach offers potential advantages in safety, comfort, and recovery over standard aCXL.
SETTING: Gemini Eye Clinic, Zlín, Czech Republic.
DESIGN: Prospective, observational, nonrandomized 1-center study.
METHODS: The study included 179 eyes (135 patients) with progressive keratoconus (grades 1 to 3-4). Patients received either epi-on CuRV (n = 77 eyes) or epi-off aCXL (n = 102 eyes) and were followed for 24 months. Distance visual acuities, refraction, maximum keratometry (Kmax), corneal thickness, wavefront aberrations, endothelial cell count, and adverse events were assessed.
RESULTS: CuRV demonstrated greater and sustained reductions in Kmax (-2.46 ± 2.64 diopters [D] vs -1.38 ± 2.13 D, P = .0018) and mean keratometry (-0.93 ± 1.62 D vs -0.52 ± 1.02 D, P = .0367) compared with aCXL over 2 years. CuRV resulted in a lower rate of Kmax increase (>1 D) compared with aCXL (1% vs 9%). Higher-order aberrations improved significantly in both groups, with greater overall reduction in the CuRV group.
CONCLUSIONS: The CuRV protocol, using topography-guided, pulsed UV-A exposure with oxygenation, effectively stabilizes keratoconus while improving corneal shape and reducing aberrations. Its noninvasive, epi-on approach offers potential advantages in safety, comfort, and recovery over standard aCXL.
Предметные рубрики MeSH
HumansKeratoconusCross-Linking ReagentsProspective StudiesPhotosensitizing AgentsVisual AcuityRiboflavinMaleFemaleUltraviolet RaysCollagenRefraction, OcularAdultPhotochemotherapyCorneal StromaEpithelium, CornealCorneal TopographyYoung AdultCell CountEndothelium, CornealAdolescentCorneal PachymetryTreatment OutcomeCorneal Wavefront Aberration