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P. Arriola Villalobos, R. Cuiña-Sardiña, D. Díaz-Valle, M. Jerez-Fidalgo, M. Jiménez-Santos, J. M. Benítez-del-Castillo, M. T. Iradier; Corneal Crosslinking With Riboflavin-UVA for Advanced Bullous Keratopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5462.
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The objetive of this study is to assess the safety and efficacy of corneal collagen cross-linking (CXL) in the management of advanced bullous keratopathy.
In this prospective noncomparative interventional case series, 6 eyes of 6 patients (1 male and 5 females) ages 58 to 89 years (mean age, 76.5 ± 11.02 years) with advanced bullous keratopathy (BK) were included. Inclusion criteria were severe pain, no pain control with therapeutic soft lens and BK history of more than 1 year. CXL was performed using 0.1% riboflavin (in 20% dextran T500) and ultraviolet A (UVA) irradiation (370 nm, 3 mW/cm2, 30 min) after epithelial debridement. Main outcome measures were pain (measured by a visual analogue scale, 0 to 10), central corneal thickness measured by Oculus Pentacam, presence of corneal epithelial bullae and best corrected visual acuity (BCVA). Complications were also analized.
CXL was performed successfully in all patients. Mean follow up was three months. All patients had pain relief, with mean pain improvement from 6 ± 2.1 to 2.5 ± 2.9 (p = 0.09). Pentacam could be performed preoperatively in three patients. A reduction of central corneal thickness was observed in those eyes. Mean preoperative central corneal thickness was reduced from 708.33 ± 140.4 to 661.33 ± 167.52 (p = 0.1). Majority of the patients experienced improvement in vision. No patient lost BCVA. Corneal epithelial bullae were fewer and smaller after treatment in all patients. Two patients developed delayed epithelization which healed after conventional treatment. There were no more complications.
CXL induced pain relief and corneal thickness decrease in advanced BK. It may be an alternative method for managing this pathology, although further studies with more patients and longer follow up are needed to ensure its safety and efectiveness.
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