PMID- 29610026 OWN - NLM STAT- MEDLINE DCOM- 20191104 LR - 20191104 IS - 1873-4502 (Electronic) IS - 0886-3350 (Linking) VI - 44 IP - 3 DP - 2018 Mar TI - Epithelial remodeling after corneal crosslinking using higher fluence and accelerated treatment time. PG - 306-312 LID - S0886-3350(18)30147-0 [pii] LID - 10.1016/j.jcrs.2017.12.021 [doi] AB - PURPOSE: To evaluate changes in regional corneal epithelial thickness after corneal crosslinking (CXL) using higher fluence (7.2 J/cm(2)) and accelerated treatment time (4 minutes) in eyes with progressive keratoconus using spectral-domain optical coherence tomography (SD-OCT) and to correlate focal epithelial and focal anterior curvature changes. SETTING: Academic medical center in the United States. DESIGN: Prospective case series. METHODS: Patients had anterior segment SD-OCT (RTVue-100) with focal stromal and epithelial measurements and Scheimpflug imaging before and 1, 3, 6, and 12 months after accelerated CXL. RESULTS: Twenty-seven eyes from 20 patients were evaluated. Before the accelerated CXL, the epithelium was thinnest in the inferior inner and outer temporal regions, whereas at 12 months postoperatively, the epithelium was significantly thinned in multiple inferior and nasal regions by 1.1 to 3.2 mum (P < .05, all measurements), with no significant changes from 6 to 12 months. Epithelial thickness standard deviation across the central 6.0 mm was significantly reduced by 3 months (1.4 mum, P = .09) and remained stable at 12 months (P = .009). Change in epithelial thickness was poorly correlated to change in anterior curvature (r = -0.035). CONCLUSIONS: Significant epithelial remodeling occurred after accelerated CXL in eyes with progressive keratoconus, with improved regularity across the central 6.0 mm, by 6 months after treatment. There was poor correlation between focal epithelial thickness and anterior curvature changes, with wide variability between patients. Establishing the pattern of epithelial remodeling after CXL might help optimize future custom treatment protocols. CI - Copyright (c) 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved. FAU - Haberman, Ilyse D AU - Haberman ID AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. FAU - Lang, Paul Z AU - Lang PZ AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. FAU - Broncano, Alvaro Fidalgo AU - Broncano AF AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. FAU - Kim, Sang Woo AU - Kim SW AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. FAU - Hafezi, Farhad AU - Hafezi F AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. FAU - Randleman, J Bradley AU - Randleman JB AD - From the Department of Ophthalmology (Haberman), New York University Langone Health, New York, New York, the Keck School of Medicine of the University of Southern California (Lang, Hafezi, Randleman), and the Roski Eye Institute (Hafezi, Randleman), University of Southern California, Los Angeles, California, USA; the Department of Cornea, Cataract & Refractive Surgery (Broncano), El Brillante Clinic, Cordoba, Spain; the Department of Ophthalmology (Kim), Ulsan University of College of Medicine, Ulsan, South Korea; the Faculty of Medicine (Hafezi), University of Geneva, Geneva and ELZA Institute (Hafezi), Dietikon/Zurich, Switzerland; the Department of Ophthalmology (Hafezi), Wenzhou Medical University, Wenzhou, China. Electronic address: randlema@usc.edu. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20180330 PL - United States TA - J Cataract Refract Surg JT - Journal of cataract and refractive surgery JID - 8604171 RN - 0 (Cross-Linking Reagents) RN - 0 (Photosensitizing Agents) RN - 9007-34-5 (Collagen) RN - TLM2976OFR (Riboflavin) SB - IM MH - Adolescent MH - Adult MH - Collagen/metabolism MH - Corneal Pachymetry MH - Corneal Stroma/*drug effects/metabolism MH - *Cross-Linking Reagents MH - Epithelium, Corneal/*physiology MH - Female MH - Humans MH - Keratoconus/*drug therapy/metabolism/physiopathology MH - Male MH - Middle Aged MH - Photochemotherapy/methods MH - Photosensitizing Agents/*therapeutic use MH - Prospective Studies MH - Riboflavin/*therapeutic use MH - Time Factors MH - Tomography, Optical Coherence/methods MH - Ultraviolet Rays MH - Visual Acuity/physiology MH - Young Adult EDAT- 2018/04/04 06:00 MHDA- 2019/11/05 06:00 CRDT- 2018/04/04 06:00 PHST- 2017/06/28 00:00 [received] PHST- 2017/11/10 00:00 [revised] PHST- 2017/12/09 00:00 [accepted] PHST- 2018/04/04 06:00 [pubmed] PHST- 2019/11/05 06:00 [medline] PHST- 2018/04/04 06:00 [entrez] AID - S0886-3350(18)30147-0 [pii] AID - 10.1016/j.jcrs.2017.12.021 [doi] PST - ppublish SO - J Cataract Refract Surg. 2018 Mar;44(3):306-312. doi: 10.1016/j.jcrs.2017.12.021. Epub 2018 Mar 30.