PMID- 17667633
OWN - NLM
STAT- MEDLINE
DCOM- 20071016
LR  - 20220408
IS  - 0277-3740 (Print)
IS  - 0277-3740 (Linking)
VI  - 26
IP  - 7
DP  - 2007 Aug
TI  - Collagen cross-linking (CCL) with sequential topography-guided PRK: a temporizing 
      alternative for keratoconus to penetrating keratoplasty.
PG  - 891-5
AB  - PURPOSE: To assess the effectiveness of ultraviolet A (UVA) irradiation-induced 
      collagen cross-linking (CCL) on keratoconus (KC) progression. METHODS: A patient 
      with bilateral, progressive KC underwent UVA irradiation (3 mW/cm for 30 minutes) 
      after topical 0.1% riboflavin drops over a deepithelialized cornea. Twelve months 
      later, a topography-guided penetrating keratoplasty (PRK; wavelight 400 Hz Eye-Q 
      excimer) was performed in 1 eye for a refractive error of -3.50 -4.00 x 155 by 
      using an attempted treatment of -2.50 -3.00 x 155. At all postoperative follow-up 
      visits to 18 months, uncorrected visual acuity (UCVA), best spectacle-corrected 
      visual acuity (BSCVA), pachymetry, and topography were performed. RESULTS: In the 
      treated left eye, the UCVA after the UVA CCL improved from 20/100 to 20/80, and 
      the BSCVA improved from 20/50 to 20/40. Eighteen months after the 
      topography-guided PRK, the UCVA was 20/20, and the BSCVA was 20/15, with a 
      refractive error of Plano -0.50 x 150. The cornea was clear, and the endothelial 
      cell count remained unchanged. The untreated right mate eye continued to progress 
      during the same period. CONCLUSIONS: The significant clinical improvement and the 
      apparent stability of more than a year after UVA CCL, and subsequent PRK compared 
      with the untreated mate eye, seems to validate this treatment approach for KC. An 
      adjusted nomogram may be considered in the ablation of cross-linked cornea tissue 
      to avoid overcorrections.
FAU - Kanellopoulos, A John
AU  - Kanellopoulos AJ
AD  - Laservision.gr Institute, Athens, Greece. laservision@internet.gr
FAU - Binder, Perry S
AU  - Binder PS
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Cornea
JT  - Cornea
JID - 8216186
RN  - 0 (Photosensitizing Agents)
RN  - 9007-34-5 (Collagen)
RN  - TLM2976OFR (Riboflavin)
SB  - IM
MH  - Adult
MH  - Cell Count
MH  - Collagen/*metabolism
MH  - Combined Modality Therapy
MH  - *Corneal Topography
MH  - Endothelium, Corneal/pathology
MH  - Humans
MH  - Keratoconus/*drug therapy/metabolism/*surgery
MH  - Lasers, Excimer
MH  - Male
MH  - *Photochemotherapy
MH  - *Photorefractive Keratectomy
MH  - Photosensitizing Agents/therapeutic use
MH  - Riboflavin/therapeutic use
MH  - Ultraviolet Rays
MH  - Visual Acuity
EDAT- 2007/08/02 09:00
MHDA- 2007/10/17 09:00
CRDT- 2007/08/02 09:00
PHST- 2007/08/02 09:00 [pubmed]
PHST- 2007/10/17 09:00 [medline]
PHST- 2007/08/02 09:00 [entrez]
AID - 00003226-200708000-00027 [pii]
AID - 10.1097/ICO.0b013e318074e424 [doi]
PST - ppublish
SO  - Cornea. 2007 Aug;26(7):891-5. doi: 10.1097/ICO.0b013e318074e424.