Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
August-2020 Volume 20 Issue 2

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
August-2020 Volume 20 Issue 2

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus

  • Authors:
    • Jin‑Rong Huang
    • Hong‑Fei Liao
    • Chun‑Hong Wan
    • Li‑Miao Gong
    • Liang‑Fei He
    • Hong‑Ji Jiang
    • Biao Li
    • Yi Shao
  • View Affiliations / Copyright

    Affiliations: Department of Ophthalmology, The Affiliated Eye Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China, Department of Ophthalmology, The First Affiliated Hospital of Jiangxi Medical College, Shangrao, Jiangxi 334000, P.R. China, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
    Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 786-795
    |
    Published online on: May 12, 2020
       https://doi.org/10.3892/etm.2020.8741
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

In the present study, the clinical and long‑term effects of accelerated transepithelial corneal collagen crosslinking (ATE‑CXL) and accelerated epithelial‑off corneal collagen crosslinking (A‑CXL) for the treatment of different types of progressive keratoconus were compared. A total of 70 patients, including 96 eyes with advanced keratoconus, were enrolled in the study. ATE‑CXL or A‑CXL was performed on one or two eyes of each subject according to corneal thickness, keratoconus type and surgical approach. Patients were divided into the following four groups: Group A, ATE‑CXL for central keratoconus; group B, A‑CXL for central keratoconus; group C, ATE‑CXL for peripheral keratoconus; and group D, A‑CXL for peripheral keratoconus. Uncorrected distant visual acuity (UDVA), best‑corrected distant (BD)VA and corneal astigmatism (CA) were evaluated in all patients by routine ophthalmology pre‑operatively and 3 years post‑operatively. Topographical features, including maximum corneal curvature (Kmax), thinnest corneal thickness (TCT), anterior corneal elevation (ACE) and corneal endothelial cell density (ECD) were also compared across groups. The results suggested that pre‑ and post‑operative UDVA, BDVA, Kmax, CA and ACE values differed in all four groups (P<0.05), whereas no differences were observed between pre‑ and post‑operative TCT and ECD (P>0.05). Concordant results were obtained between groups A and C and groups B and D. ATE‑CXL achieved better control of central keratoconus UDVA, Kmax and CA as compared with A‑CXL. The difference between pre‑ and post‑operative UDVA, Kmax and CA as compared with A‑CXL was highly correlated with the change in intraocular pressure and treatment effectiveness. There was a statistically significant improvement in BDVA with ATE‑CXL for treatment of central keratoconus compared with that after A‑CXL treatment (P=0.032). There were statistically significant improvements in BDVA (P=0.047), CA (P=0.045) and ACE (P=0.012) with A‑CXL treatment of peripheral keratoconus when compared with ATE‑CXL treatment. Central, and to a lesser extent, peripheral, keratoconus may be effectively controlled by either approach, with disease stabilization 3 years later. ATE‑CXL is suggested to be the most suitable treatment for keratoconus of <400 µm with a corneal thickness of >400 µm; however, A‑CXL yields superior long‑term outcomes.
View Figures

Figure 1

Figure 2

Figure 3

View References

1 

Shalchi Z, Wang X and Nanavaty MA: Safety and efficacy of epithelium removal and transepit helial corneal collagen crosslinking for keratoconus. Eye (Lond). 29:15–29. 2015.PubMed/NCBI View Article : Google Scholar

2 

Baum J: On the location of the cone and the etiology of keratoconus. Cornea. 14:142–143. 1995.PubMed/NCBI

3 

Wollensak G: Crosslinking treatment of progressive keratoconus: New hope. Curr Opin Ophthalmol. 17:356–360. 2006.PubMed/NCBI View Article : Google Scholar

4 

Alió JL and Shabayek MH: Corneal higher order aberrations: A method to grade keratoconus. J Refract Surg. 22:539–545. 2006.PubMed/NCBI

5 

Prausnitz MR and Noonan JS: Permeability of cornea, sclera, and conjunctiva: A literature analysis for drug delivery to the eye. J Pharm Sci. 87:1479–1488. 1998.PubMed/NCBI View Article : Google Scholar

6 

Hoyer A, Raiskup-Wolf F, Spörl E and Pillunat LE: Collagen cross-linking with riboflavin and UVA light in keratoconus.results from Dresden. Ophthalmologe. 106:133–140. 2009.PubMed/NCBI View Article : Google Scholar : (In German).

7 

Wollensak G, Spoerl E and Serler T: Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 135:620–627. 2003.PubMed/NCBI View Article : Google Scholar

8 

Santhiago MR, Giacomin NT, Medeiros CS, Smadja D and Bechara SJ: Intense early flattening after corneal collagen cross-linking. J Refract Surg. 31:419–422. 2015.PubMed/NCBI View Article : Google Scholar

9 

Sel S, Nass N, Pötzsch S, Trau S, Simm A, Kalinski T, Duncker GI, Kruse FE, Auffarth GU and Brömme HJ: UVA irradiation of riboflavin genetates oxygen-dependent hydroxyl radicals. Redox Rep. 19:72–79. 2014.PubMed/NCBI View Article : Google Scholar

10 

Kopsachilis N, Tsaousis KT, Tsinopoulos IT, Kruse FE and Welge-Luessen U: A novel mechanism of UVA and ribollavin-mediated corneal cross-linking through induction of tissue transglutaminases. Cornea. 32:1034–1039. 2013.PubMed/NCBI View Article : Google Scholar

11 

O'Brart DP: Corneal collagen cross-1inking: A review. J Optom. 7:113–124. 2014.PubMed/NCBI View Article : Google Scholar

12 

Leccisotti A and Islam T: Transepithelial corneal collagen cross-linking in keratoconus. J Refract Surg. 26:942–948. 2010.PubMed/NCBI View Article : Google Scholar

13 

Caporossi A, Baiocchi S, Mazzotta C, Traversi C and Caporossi T: Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: Preliminary refractive results in an Italian study. J Cataract Refract Surg. 32:837–845. 2006.PubMed/NCBI View Article : Google Scholar

14 

Mencucci R, Mazzotta C, Rossi F, Ponchietti C, Pini R, Baiocchi S, Caporossi A and Menchini U: Riboflavin and ultraviolet A Collagen crosslinking: In vivo thermographic analysis of the corneal surface. J Cataract Refract Surg. 33:1005–1008. 2007.PubMed/NCBI View Article : Google Scholar

15 

Spoerl E, Mrochen M, Sliney D, Trokel S and Seiler T: Safty of UVA-riboflavin cross-linking of the cornea. Cornea. 26:385–389. 2007.PubMed/NCBI View Article : Google Scholar

16 

Koller T, Mrochen M and Seiler T: Complication and failure rates after corneal crosslinking. J Cataract Refract Surg. 35:1358–1362. 2009.PubMed/NCBI View Article : Google Scholar

17 

Hafezi F, Mrochen M, Iseli HP and Seiler T: Collagen crosslinking with ultraviolet-A and hypoosmolar riboflavin solution in thin corneas. J Cataract Refract Surg. 35:621–624. 2009.PubMed/NCBI View Article : Google Scholar

18 

Mazzotta C, Balestrazzi A, Baiocchi S, Traversi C and Caporossi A: Stromal haze after combined riboflavin-UVA corneal collagen cross-linking in keratoconus: In vivo confocal microscopic evaluation. Clin Exp Ophthalmol. 35:580–582. 2007.PubMed/NCBI View Article : Google Scholar

19 

Kymionis GD, Portaliou DM, Bouzoukis DI, Suh LH, Pallikaris AI, Markomanolakis M and Yoo SH: Herpetic keratitis with iritis after corneal crosslinking with riboflavin and ultraviolet A for keratoconus. J Cataract Refract Surg. 33:1982–1984. 2007.PubMed/NCBI View Article : Google Scholar

20 

Nagy ZZ: Laser in situ keratomileusis combined with topography-supported customized ablation after repeated penetrating keratoplasty. J Cataract Refract Surg. 29:792–794. 2003.PubMed/NCBI View Article : Google Scholar

21 

Spöerl E, Huhle M, Kasper M and Seiler T: Increased rigidity of the cornea caused by intrastromal cross-linking. Ophthalmologe. 94:902–906. 1997.PubMed/NCBI View Article : Google Scholar : (In German).

22 

Meek KM, Tuft SJ, Huang Y, Gill PS, Hayes S, Newton RH and Bron AJ: Changes in collagen orientantion and distribution in keratoconus corneas. Invest Ophthalmol Vis Sci. 46:1948–1956. 2005.PubMed/NCBI View Article : Google Scholar

23 

Wollensak G, Spoerl E, Wilsch M and Seiler T: Endothelial cell damage after riboflavin-ultraviolet-A treatment in the rabbit. J Cataract Refract Surg. 29:1786–1790. 2003.PubMed/NCBI View Article : Google Scholar

24 

Spoerl E, Wollensak G and Seiler T: Increased resistance of crosslinked cornea against enzymatic digestion. Curr Eye Res. 29:35–40. 2004.PubMed/NCBI View Article : Google Scholar

25 

Spoerl E, Wollensak G, Dittert DD and Seiler T: Thermomechanical behaviour of collagen-cross-linked porcine cornea. Ophthalmologica. 218:136–140. 2004.PubMed/NCBI View Article : Google Scholar

26 

Wollensak G, Spoerl E and Seiler T: Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet-A-induced cross-linking. J Cataract Refract Surg. 29:1780–1785. 2003.PubMed/NCBI View Article : Google Scholar

27 

Wen D, Song B, Li Q, Tu R, Huang Y, Wang Q, McAlinden C, O'Brart D and Huang J: Comparison of epithelium-Off versus transepithelial corneal collagen cross-linking for keratoconus: A systematic review and meta-analysis. Cornea. 37:1018–1024. 2018.PubMed/NCBI View Article : Google Scholar

28 

Kim EJ, Sajjad A, Montes de Oca I, Koch DD, Wang L, Weikert MP and Al-Mohtaseb ZN: Refractive outcomes after multifocal intraocular lens exchange. J Cataract Refract Surg. 43:761–766. 2017.PubMed/NCBI View Article : Google Scholar

29 

Whitacre MM, Stein RA and Hassanein K: The effect of corneal thickness on applanationn tonometry. Am J Ophthalmol. 115:592–596. 1993.PubMed/NCBI View Article : Google Scholar

30 

Bonomi L, Mecca E and Massa F: Intracular pressure in myopic anisometropia. Int Ophthalmol. 5:145–148. 1982.PubMed/NCBI View Article : Google Scholar

31 

Wong TY, Klein BE, Klein R, Knudtson M and Lee KE: Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology. 110:211–217. 2003.PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Huang JR, Liao HF, Wan CH, Gong LM, He LF, Jiang HJ, Li B and Shao Y: Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus. Exp Ther Med 20: 786-795, 2020.
APA
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H. ... Shao, Y. (2020). Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus. Experimental and Therapeutic Medicine, 20, 786-795. https://doi.org/10.3892/etm.2020.8741
MLA
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H., Li, B., Shao, Y."Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus". Experimental and Therapeutic Medicine 20.2 (2020): 786-795.
Chicago
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H., Li, B., Shao, Y."Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus". Experimental and Therapeutic Medicine 20, no. 2 (2020): 786-795. https://doi.org/10.3892/etm.2020.8741
Copy and paste a formatted citation
x
Spandidos Publications style
Huang JR, Liao HF, Wan CH, Gong LM, He LF, Jiang HJ, Li B and Shao Y: Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus. Exp Ther Med 20: 786-795, 2020.
APA
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H. ... Shao, Y. (2020). Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus. Experimental and Therapeutic Medicine, 20, 786-795. https://doi.org/10.3892/etm.2020.8741
MLA
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H., Li, B., Shao, Y."Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus". Experimental and Therapeutic Medicine 20.2 (2020): 786-795.
Chicago
Huang, J., Liao, H., Wan, C., Gong, L., He, L., Jiang, H., Li, B., Shao, Y."Three‑year clinical observation of the outcomes of transepithelial and epithelial‑off accelerated corneal collagen crosslinking treatment for different types of progressive keratoconus". Experimental and Therapeutic Medicine 20, no. 2 (2020): 786-795. https://doi.org/10.3892/etm.2020.8741
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team