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NR. 2/2009
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Zastosowanie metody
cross-linking w leczeniu stożka rogówki – obserwacje własne
Corneal Cross-Linking in Keratoconus Treatment – Own Experience
Justyna Izdebska1,3,
Iwona Grabska-Liberek2,3, Jerzy Szaflik1,3
1Katedra i Klinika Okulistyki II Wydziału Lekarskiego
Warszawskiego Uniwersytetu Medycznego
Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2Klinika Okulistyki Centrum Medycznego Kształcenia
Podyplomowego w Warszawie
Kierownik: dr hab. n. med. Iwona Grabska-Liberek
3Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik |
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| Summary: |
Corneal Cross-Linking.
Topical treatment with ryboflavin and exposure to
ultraviolet A (365 nm) light consists in the
photopolymerization of the stromal collagen fibers with
the intent of increasing rigidity of the cornea and
resistance to keratectasia. The treatment was originally
introduced in Germany during the mid ’90 s by group of
researches of the Technicak University of Dresden by
Gregor Wollensak, Theo Seiler and Eberhard Spoerl with
the objective to slow down or arrest the progression of
keratoconus and thus to avoid or at least to delay the
necessity of keratoplasty
Purpose: To evaluate predictability, stability, and
safety of Corneal Cross Linking (CXL).
Patients and Methods: In 152 eyes (108 patients) CxL was
performed in Microsurgery Eye Center LASER Warsaw Poland
between January 2007and April 2008. The progresive
keratoconus at 1 or 2 degree without scars was diagnosed
in all eyes. Procedure was done under topical anesthesia.
After corneal deepithelization (diameter 9 mm) and
instillation of riboflavin phosphate 20% dextran T 500
solution every 5 minutes for 30 minutes. UVA radiation (energy
3 mW/ cm2) was applied for 30 minutes. The following
parameters was analyzed: UCVA, BCVA, mean K, pachymetry,
IOP at 1, 6, 12 months. The complications of the
procedure were also assessed.
Results: UCVA and BCVA were improved (>1 line) in 76.3%
(116 eyes), in 5 cases was worse at the post operative
period. Kmax values were lower (mean 1.4 D) in all cases
during whole period. No progression of keratoconus was
observed after 1 year. There was no changes in
pachymetry and IOP. The clinically significant stromal
haze was observed in 136 (89.5%) cases during first 3
months after CxL.
Conclusions: The Corneal Cross Linking ( CXL) is an
effective method for stabilizations of progressive
keratoconus. The method is safe with good tolerance by
patients. CxL doesn’t exclude the possibility to perform
other procedures for such patients in the future. |
| Key words: |
keratoconus, Corneal
Cross-Linking. |
| Słowa kluczowe: |
stożek rogówki, metoda
corneal cross-linking. |
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