Abstract | PURPOSE: Since 1998 collagen cross-linking is used for patients with progressive keratoconus. Today it can almost be considered as the standard therapy. METHODS: Patients with progressive keratoconus and minimal corneal thickness of 400 µm have been cross-linked within a study - (EK 310 499) approved by the ethical committee since 1998. An increase of the maximum K-value by ≥ 1 D within the last year, patient's statement of deteriorating visual acuity or the necessity of new contact len fitting more than once in 2 years were considered as progression. RESULTS: The analysis includes 153 eyes of 111 patients with a minimal follow-up of 12 months and a maximum follow-up of 6 years. The keratectasia significantly decreased in the 1 (st) year by 2.28 D. The visual acuity improved significantly by at least one line or, respectively, remained stable (i. e., no line loss) in the 1st year in 73 %. The results remained stable over the next two years. Despite the low number of patients with a follow-up longer than 3 years and therefore limited statistical statement power, our results still indicate a long-term stabilisation or, respectively, improvement after collagen cross-linking. We saw no severe side-effects. Three patients with an exacerbated neurodermitis showed continuous progression of keratoconus and were cross-linked again. CONCLUSIONS: To date there have been numerous promising publications on collagen cross-linking for keratoconus. The results of this study indicate that collagen cross-linking appears to be an effective therapeutic option for progressing keratoconus. Besides the clinical there are enormous economical and psychosocial benefits. Cross-linking is an out-patient, minimally-invasive, cost-effective treatment with minimal strain for the persons concerned.
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Authors | A Hoyer, E Spörl, L E Pillunat |
Journal | Klinische Monatsblatter fur Augenheilkunde
(Klin Monbl Augenheilkd)
Vol. 227
Issue 9
Pg. 723-8
(Sep 2010)
ISSN: 1439-3999 [Electronic] Germany |
Vernacular Title | Kollagenvernetzung mit Riboflavin und UVA-Licht. |
PMID | 20602296
(Publication Type: English Abstract, Journal Article, Review)
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Copyright | © Georg Thieme Verlag KG Stuttgart · New York. |
Chemical References |
- Cross-Linking Reagents
- Collagen
- Riboflavin
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Topics |
- Adult
- Ambulatory Care
- Collagen
(metabolism)
- Combined Modality Therapy
- Corneal Stroma
(drug effects, pathology)
- Cross-Linking Reagents
(administration & dosage)
- Female
- Follow-Up Studies
- Humans
- Keratoconus
(diagnosis, drug therapy, etiology, pathology)
- Male
- Riboflavin
(administration & dosage)
- Ultraviolet Therapy
- Visual Acuity
(drug effects)
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