PMID- 24763478
OWN - NLM
STAT- MEDLINE
DCOM- 20140527
LR  - 20140425
IS  - 1081-597X (Print)
IS  - 1081-597X (Linking)
VI  - 30
IP  - 2
DP  - 2014 Feb
TI  - Epithelial and stromal remodeling after corneal collagen cross-linking evaluated 
      by spectral-domain OCT.
PG  - 122-7
LID - 10.3928/1081597X-20140120-08 [doi]
AB  - PURPOSE: To evaluate changes in corneal epithelial and stromal thickness after 
      corneal collagen cross-linking (CXL) in eyes with keratoconus and postoperative 
      corneal ectasia using spectral-domain optical coherence tomography (SD-OCT). 
      METHODS: Anterior segment SD-OCT (RTVue-100; Optovue, Inc., Fremont, CA) was used 
      to compare regional corneal epithelial and stromal thickness in eyes with 
      keratoconus and ectasia before CXL and 1 and 3 months after CXL. The anterior 
      surface of the cornea, epithelium-Bowman's layer interface, and posterior 
      reflective surface were used as anatomical landmarks to measure epithelial and 
      stromal thickness, respectively. Regional thickness was assessed centrally and at 
      21 points 0.5 mm apart across the central 6 mm of the corneal vertex in the 
      horizontal and vertical meridians. RESULTS: Thirty-one eyes from 30 patients were 
      evaluated, including 17 eyes (17 patients) with keratoconus and 14 eyes (13 
      patients) with ectasia. Preoperatively, a highly irregular epithelial thickness 
      profile and distribution was observed in both groups. After CXL, epithelial 
      thickness was significantly thinner 2.5 and 2 mm below and 1.5 mm above the 
      corneal apex (49.26 +/- 5.69 mum; range: 43 to 62 mum), and 2.5 and 1 mm nasal and 2 
      mm temporal to the corneal apex (46.66 +/- 4.53 mum; range: 39 to 57 mum) compared to 
      preoperative values (P < .05 for all measurements). Epithelial thickness standard 
      deviations were significantly lower (by 3 to 6 mum) 3 months after CXL, compared 
      to ranges before CXL in both the vertical and horizontal meridians for 
      keratoconus and ectasia (P = .048). No significant differences were found between 
      epithelial remodeling in keratoconus and corneal ectasia (P = .98). No 
      significant or consistent stromal changes were found for either group. 
      CONCLUSIONS: Significant epithelial remodeling occurs after CXL in eyes with 
      keratoconus and corneal ectasia, creating a similar, more regularized thickness 
      profile in all meridians in the early postoperative period. This pattern of 
      remodeling may facilitate interpretation of corneal curvature and thickness 
      changes after CXL and may be related to visual acuity after CXL.
CI  - Copyright 2014, SLACK Incorporated.
FAU - Rocha, Karolinne Maia
AU  - Rocha KM
FAU - Perez-Straziota, Claudia E
AU  - Perez-Straziota CE
FAU - Stulting, R Doyle
AU  - Stulting RD
FAU - Randleman, J Bradley
AU  - Randleman JB
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Refract Surg
JT  - Journal of refractive surgery (Thorofare, N.J. : 1995)
JID - 9505927
RN  - 0 (Cross-Linking Reagents)
RN  - 0 (Photosensitizing Agents)
RN  - 9007-34-5 (Collagen)
RN  - TLM2976OFR (Riboflavin)
SB  - IM
EIN - J Refract Surg. 2014 Mar;30(3):171. Rocha, Karoline Maia [corrected to Rocha, 
      Karolinne Maia]
MH  - Collagen/*metabolism
MH  - Corneal Stroma/*physiology
MH  - Cross-Linking Reagents/*therapeutic use
MH  - Dilatation, Pathologic/drug therapy/physiopathology
MH  - Epithelium, Corneal/*physiology
MH  - Humans
MH  - Keratoconus/*drug therapy/physiopathology
MH  - Photosensitizing Agents/therapeutic use
MH  - Prospective Studies
MH  - Refraction, Ocular/physiology
MH  - Riboflavin/therapeutic use
MH  - *Tomography, Optical Coherence
MH  - Treatment Outcome
MH  - Ultraviolet Rays
MH  - Visual Acuity/physiology
EDAT- 2014/04/26 06:00
MHDA- 2014/05/28 06:00
CRDT- 2014/04/26 06:00
PHST- 2013/06/16 00:00 [received]
PHST- 2013/10/10 00:00 [accepted]
PHST- 2014/04/26 06:00 [entrez]
PHST- 2014/04/26 06:00 [pubmed]
PHST- 2014/05/28 06:00 [medline]
AID - 10.3928/1081597X-20140120-08 [doi]
PST - ppublish
SO  - J Refract Surg. 2014 Feb;30(2):122-7. doi: 10.3928/1081597X-20140120-08.