Four Year Results Of Four Year Results Of Corneal Crosslinling Corneal Crosslinling (XL) in Keratoconus (XL) in Keratoconus Fernando Aguilera-Zarate MD Fernando Aguilera-Zarate MD Instituto de Ojos de BC Instituto de Ojos de BC Mexicali, Baja California Mexicali, Baja California Mexico Mexico No Financial Interest No Financial Interest
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Four Year Results Of Corneal Crosslinling (XL) in Keratoconus
Four Year Results Of Corneal Crosslinling (XL) in Keratoconus. Fernando Aguilera-Zarate MD Instituto de Ojos de BC Mexicali, Baja California Mexico No Financial Interest. Objective > Corneal Rigidity Fotopolimerization colagen Fibers Combination : UV-A + Rivoflabin ( vit B2) - PowerPoint PPT Presentation
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Four Year Results Of Four Year Results Of Corneal Crosslinling Corneal Crosslinling (XL) in Keratoconus(XL) in Keratoconus
Fernando Aguilera-Zarate MDFernando Aguilera-Zarate MD Instituto de Ojos de BCInstituto de Ojos de BC Mexicali, Baja CaliforniaMexicali, Baja California MexicoMexico
Chemical Reaction that transforms molecules Chemical Reaction that transforms molecules of low molecular mass (monomers) of low molecular mass (monomers) producing high molecular weight molecules producing high molecular weight molecules (polymers)(polymers)
Used in Odontology since the early 70’sUsed in Odontology since the early 70’s
Used in Tire and Textil Industries for more Used in Tire and Textil Industries for more than 5 decadesthan 5 decades
WOOLENSAK,SEILER
AJO,2003;135:625-627First Report Of Humans Treated by XL
Results:
Regresion KC …………………….72%
< Spherical Equivalent……………1.34 D
< Astigmatism.. ……………………2.01 D
Control Group, progression………..22 %
CROSSLINKING CROSSLINKING OBJECTIVEOBJECTIVE
Document 4 year follow-up changes Document 4 year follow-up changes in Corneal Refractive, Topography in Corneal Refractive, Topography and Aberrometry; and to evaluate and Aberrometry; and to evaluate the Visual Quality Improvement in the Visual Quality Improvement in Keratoconus corneas Treated by Keratoconus corneas Treated by UV-B CrosslinkingUV-B Crosslinking
No concurrent ophthalmic diseases No concurrent ophthalmic diseases KC (I-III with confirmed progression by KC (I-III with confirmed progression by
topography)topography) Corneal paquimetry >400 um at thinnest pointCorneal paquimetry >400 um at thinnest point Normal Cristaline Lens Densitometry (pentacam)Normal Cristaline Lens Densitometry (pentacam) Normal Retinal OCTNormal Retinal OCT Specular Microscopy (Tomey SM 3000)Specular Microscopy (Tomey SM 3000)
Surgery (Corneal Surgery (Corneal Crosslinking)Crosslinking)
Reduction of true net power Reduction of true net power
ElevationElevation: Reduction Anterior/Posterior Reduction Anterior/Posterior Elevation. More Reduction in Ectatic AreasElevation. More Reduction in Ectatic Areas
Coma (z3,-1; z3,1) Coma (z3,-1; z3,1) and trifoil (z3,-3; and trifoil (z3,-3; z3,3)z3,3)
Refractive:Refractive:< Irregular Ast./change in < Irregular Ast./change in axis<10°axis<10°
Pachymetric and Corneal Pachymetric and Corneal Power:Power:< optic pachymetry / < total corneal power< optic pachymetry / < total corneal power
Visual Quality:Visual Quality: mtf improvement at lower frequencies(5-10 mtf improvement at lower frequencies(5-10 c/d)c/d)
Visual Quality Improvement Visual Quality Improvement Related with Reduced Spherical Related with Reduced Spherical Equivalent and Reduction Corneal Equivalent and Reduction Corneal HOAHOA
Reduction Reduction Corneal Irregularity IndicesCorneal Irregularity Indices
XL Early Complications (15 d)XL Early Complications (15 d)
Improves Corneal Biomechanics > RigidityImproves Corneal Biomechanics > Rigidity < Corneal Asimetry< Corneal Asimetry < Corneal Tertiary Higher Order Ab < Corneal Tertiary Higher Order Ab (coma / (coma /
trifoil) trifoil) < Refractive Corneal Power (true net power)< Refractive Corneal Power (true net power) > Visual Quality (MTF y PSF)> Visual Quality (MTF y PSF) < Pachimetry (Corneal Remodeling)< Pachimetry (Corneal Remodeling)
CONCLUSION CONCLUSION 4 Year Followup of 4 Year Followup of Corneal XLCorneal XL
Effective Therapeutic Modality to Effective Therapeutic Modality to Prevent or Reduce progresion of Ectatic Prevent or Reduce progresion of Ectatic Changes associated with KeratoconusChanges associated with Keratoconus
Improves Optical Qualities of CorneaImproves Optical Qualities of Cornea