Intraoperative and Long-Term Corneal Biomechanical Changes in Crosslinked Keratoconic Eyes Elena Albé MD Elena Albé MD Paolo Vinciguerra MD, Paolo Vinciguerra MD, Silvia Trazza, MD Silvia Trazza, MD EYE OCULISTICA Istituto Clinico Humanitas Rozzano, MI, Italy Direttore: Paolo Vinciguerra, MD Boston, ASCRS, April, 2010 Financial discosure: I do not have any financial interest or relationship to disclose. P253
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Intraoperative and Long-Term Corneal Biomechanical Changes in Crosslinked Keratoconic Eyes
Elena Albé MD Paolo Vinciguerra MD, Silvia Trazza, MD. P253. Boston, ASCRS, April, 2010. Intraoperative and Long-Term Corneal Biomechanical Changes in Crosslinked Keratoconic Eyes. Financial discosure: I do not have any financial interest or relationship to disclose. EYE OCULISTICA - PowerPoint PPT Presentation
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Intraoperative and Long-Term Corneal Biomechanical Changes
in Crosslinked Keratoconic Eyes
Elena Albé MD Elena Albé MD
Paolo Vinciguerra MD, Paolo Vinciguerra MD,
Silvia Trazza, MD Silvia Trazza, MD
EYE OCULISTICA Istituto Clinico Humanitas
Rozzano, MI, ItalyDirettore: Paolo Vinciguerra, MD
Boston, ASCRS, April, 2010
Financial discosure: I do not have any financial interest or relationship to disclose.
P253
AIM of the STUDYTo analyze the biomechanical properties of 24 keratoconic corneas
Amsler grade II undergoing CXL and correlate the intraoperative biomechanical and geometrical change
t 1 baseline preCXL witht 2 after epithelium removal preCXL sinet 3 after impregnation before UVA preCXL sine2t 4 after CKL procedure postCXL sinet 5 after reepithelialization postCXL with
1,6,12 and 24 months after CXL by means of CSO TOPOGRAPHER OCULAR RESPONSE ANALYZER PENTACAM
CROSS LINKING PROCEDURE•2% Pilocarpine drops and antipain meds 30 min before CXL.•Oxybuprocaine hydrochloride 0.2% 5 min before CXL.•LASER TEST UVA meter
•Laser 370±5 nm•Power 3 mW/cm2 (= 5.4 j/cm2)
•RICROLIN riboflavin 0.1% solution instillation each minute for 30 min•Riboflavin check absorption in anterior chamber (flare).•UVA Light Corneal irradiation PESCKE X-Linker 7.5 mm Ø. •RICROLIN instillation 6 times of 5 min each•Bandage soft CL application and levofloxacin eyedrops
Epithelium removalIncreases corneal curvature Reduces corneal thickness Reduces light detected during applanation peaks Does not influence corneal biomechanical
properties CH and CRF
MullerLJ, Pels E, Vrensen GFJM. The specific architecture of the anterior stroma accounts for the maintenance of corneal curvature. BJO.2001;85:437-43 The specific architecture of the most anterior part of the corneal stroma (100-120 microns) has been suggested to be responsible for the stability of the corneal shape.Gatinel D, Chaabouni S, Adam PA, Munck J, Puech M, Hoang-Xuan T. Corneal hysteresis, resistance factor, topography, and pachymetry after corneal lamellar flap. JRS.2007;23:76-84The creation of a stromal flap can modify the biomechanical properties of the cornea, including a reduction of corneal hysteresis
CONCLUSIONWhat Happens after Cross Linking?
• T-dextran and riboflain dehydrate cornea along CXL