EFFICACY OF TRANSEPITHELIAL ACCELERATED COLLAGEN CROSS LINKING IN STOPPING THE PROGRESSION OF KERATOCONUS

Authors

  • Imran Ahmad Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan
  • Nazli Gul Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan
  • Bilal Khan Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan
  • Jahandad Khan Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan
  • Mutasim Rasheed Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan
  • Fahad Khan Department of Ophthalmology, KMC/ Khyber Teaching Hospital Peshawar-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-12672

Keywords:

corneal cross-linking, keratoconus

Abstract

Background: Keratoconus is a progressive ectatic disease of the cornea leading to central corneal thinning, protrusion and permanent visual impairment in untreated cases. It is affecting young children with strong association to vernal keratoconjunctivitis a common disease of Asian countries. Corneal collagen cross linkage (CXL) is standard procedure to stop progression of keratoconus. In this research article we used trans-epithelial accelerated corneal cross-linking to check its efficacy in stopping the progression of disease as quick and safe procedure with less chances of complication than standard CXL protocol. Methods: The study was carried out in Khyber Teaching Hospital from November 2022-October 2023. The sample size calculated was 36 with sampling technique of non-probability consecutive convenience sampling method. Results: The mean age of the patients was 19.157±3.53 years. Post corneal cross-linking, at 6 months follow-up showed that in 94.44% of the patients, no progression of keratoconus was noted. Improvement in vision was recorded in 44.44% of patients. A positive correlation was detected between pre- and post-treatment patients in visual acuity, keratometry and pachymetry. Conclusion: The trans-epithelial accelerated corneal collagen crosslinking is a safe and quick procedure for stopping the progression of keratoconus associated with less morbidity and complications.

References

Payne AO, Figuerola AA, Bogantes EH, Aguilar LP, Chan E, Godefrooij D. Optimal management of pediatric keratoconus: challenges and solutions. Clin Ophthalmol 2019(10);13:1183-91.

Ali W, Sharif R, Khan FU, Khan S. Topography pattern in keratoconusobserved at Al-shifa trust eye hospital Rawalpindi. Al-Shifa J Ophthalmol 2022;18(2):55-9.

Wajnsztajn D, Soloman A. Vernal keratoconjunctivitis and keratoconus. Curr Opin Allergy Clin Immunol 2021;21(5):507-14.

Singh B, Yadav N, Ranjan R, Singh AP, Kumar G. A comparative study of Rebamipide, cyclosporine and Olopatidine in the treatment of vernal keratoconjunctivitis in the rural population of central India. Int J Life Sci Biotechnol Pharma Res. 2022;11(2):45-52.

Perez-Straziota C, Gaster RN, Rabinowitz YS. Corneal Cross-linking for pediatric keratoconus review. Cornea 2018;37(6):802-9.

Hafezi F, Richoz O, Torres-Netto EA, Hillen M, Hafezi NL. Corneal cross-linking at the slit lamp. J Refract Surg 2021;37(2):78-2.

Spadea L, Tonti E, Vingolo EM. Corneal stromal demarcation line after collagen cross-linking in corneal ectatic diseases: A review of literature. Clin Ophthalmol 2016;10:1803-10.

Mohammadpour M, Heidari Z, Hashemi H. Update on management for keratoconus. J Curr Ophthalmol 2017;30(2):110-24.

Zhu AY, Jun AS, Soiberman US. Combined protocols for corneal cross-linking with photorefractive surgery for refractive management of keratoconus: Update on technique and review of literature. Ophthalmol Ther 2019;8(1):15-31.

Wollensak G, Spoerl E, Seiler T. Riboflavin /ultraviolet induced collagen cross linking for the treatment of keratoconus. Am J Ophthalmol 2003;135(5):620-7.

Dervenis N, Dervenis P, Dragoumis N, Papandroudis P, Zachariadis Z, Balidis M. Acclerated, pulsed collagen cross-linking versus the Dresden protocol in keratoconus: A case series. Med Princ Pract 2020;29(4):332-7.

Gokhale NS. Epidemiology of keratoconus. Indian J Ophthalmol 2023;61(8):382-3.

Ting DS, Reman RR, Chen Y, Bell D, Danjoux P, Morgan SJ, et al. Effectiveness and safety of accelerated (9mW/cm2) corneal collagen cross-linking for progressive keratoconus: a 24 onths follow up. Eye (Lond) 2019;33(5):812-8.

Henriquez MA, Villegas S, Rincon M, Maldonado C, Izquierdo L. Long term efficacy and safety after corneal collagen crosslinking in pediatric patients: three years follow-up. Eur J Ophthmol 2018;28(4):415-8.

Nicula C, Pop R, Rednik A, Nicula D. 10 years results of standard cross linking in patients with progressive keratoconus in Romania. J Ophthalmol 2019;8:285-9.

Salman MA, Darwish TR, Haddad YH, Shabaan RH, Askar MZ. Accelerated versus standard corneal cross-linking for progressive keratoconus in Syria. J Ophthalmic Vis Res 2021;16(3):338-48.

Mazzotta C, Raiskup F, Hafezi F, Torres-Netto EA, Balamoun AA, Giannaccare G, et al. long-term results of accelerated 9mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross study 2. Eye Vis (Lond) 2021:8(1):16-9.

Madeira C, Vasques A, Beato J, Godinho G, Torrao L, Falcao M, et al. Transepithelial accelerated versus conventional corneal collagen crosslinking in patients with keratconus. Clin Ophthalmol 2019;13:445-52.

Iqbal M, Ekmassry A, Saad H, Gad AA, Ibrahim O, Hamed N. Standard corneal crosslinking protocol versus accelerated trans-epithelial cross-linking protocol for treatment of pediatrics keratoconus: a 2 years comparative study. Acta Ophthalmol 2020;98(3):352-62.

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Published

2024-06-30

How to Cite

Ahmad, I., Gul, N., Khan, B., Khan, J., Rasheed, M., & Khan, F. (2024). EFFICACY OF TRANSEPITHELIAL ACCELERATED COLLAGEN CROSS LINKING IN STOPPING THE PROGRESSION OF KERATOCONUS. Journal of Ayub Medical College Abbottabad, 36(2), 284–288. https://doi.org/10.55519/JAMC-02-12672