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M. Poli, C. Burillon; A Prospective Trial of Collagen Cross-Linking in Keratoconus and Post-Lasik Ectasia: Preliminary Results. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5481.
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This trial aims to provide evidence in relation to the efficacy and safety of corneal collagen cross-linking (CXL) in the management of progressive keratoconus and post-LASIK ectasia.
prospective nonrandomized monocenter trial. Progressive keratoconus and post-LASIK ectasia with a 400µ minimal pachymetry were included. CXL was performed using 0.1% riboflavin (in 20% dextran T500) and ultraviolet A (UVA) irradiation (370 nm, 3 mW/cm2, 30 min) in accordance with the Siena University protocol. A complete ophthalmologic examination including visual acuity testing, slit-lamp examination, corneal ultrasound pachymetry, corneal topography and measurement of endothelial cell density, were performed at 1, 3, 6 months and 1 year. The follow-up time was between 3 months and 1 year.
38 eyes of 34 patients with moderate or advanced progressive keratoconus and post-LASIK ectasia were included (32 eyes with keratoconus and 5 with post-LASIK ectasia). Interim analysis of treated eyes showed a trend toward what seems an improvement in visual acuity and a flattening of the steepest simulated keratometry value in keratoconus. CXL of the post-LASIK ectasia leads in most cases to a halt of the progression.So far, no strong complications have been reported.
Preliminary results of this trial suggest a temporary stabilization of all treated keratoconic eyes after CXL. Better results are obtained in case of keratoconus than in case of post-LASIK ectasia. Further studies are necessary to evaluate the duration of the stiffening effect and to exclude long term side-effects.
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