Transepithelial crosslinking retreatment of progressive corneal ectasia unresponsive to classic crosslinking.

MedStar author(s):
Citation: Journal of Cataract & Refractive Surgery. 43(1):131-135, 2017 JanPMID: 28317666Institution: MedStar Washington Hospital CenterDepartment: OphthalmologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Corneal Diseases | *Keratomileusis, Laser In Situ | Adult | Collagen | Cornea | Corneal Diseases/th [Therapy] | Dilatation, Pathologic | Humans | Keratomileusis, Laser In Situ/mt [Methods] | Male | Retreatment | Riboflavin/ad [Administration & Dosage] | Visual AcuityYear: 2017Local holdings: Available online through MWHC library: 1999 - 2010, Available in print through MWHC library:1999-2007ISSN:
  • 0886-3350
Name of journal: Journal of cataract and refractive surgeryAbstract: A 41-year-old man presented 10 years after uneventful laser in situ keratomileusis (LASIK) with symptomatic post-LASIK ectasia. He had treatment with the classic Dresden epithelium-off technique and presented 4 years later with progression of the ectasia. He was subsequently retreated with conductive keratoplasty (CK) followed by a new proprietary epithelium-on corneal collagen crosslinking (CXL) procedure using a proprietary transepithelial riboflavin formulation and delivery system on the following day. One year after retreatment, the patient noted stable vision in the treated eye with a corrected distance visual acuity (CDVA) of 20/60<sup>+</sup>. Thus, epithelium-on CXL, if performed with appropriate formulations and delivery technology as well as careful attention to appropriate riboflavin loading of the stroma, can stabilize an ectatic cornea. In addition, when performed prior to CXL, CK can induce a significant, lasting improvement in corneal shape and CDVA. This technique merits further study.Copyright (c) 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.All authors: Choi M, Epstein RH, Epstein RJ, Kim D, Majmudar PA, Rubinfeld RSFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28317666 Available 28317666

Available online through MWHC library: 1999 - 2010, Available in print through MWHC library:1999-2007

A 41-year-old man presented 10 years after uneventful laser in situ keratomileusis (LASIK) with symptomatic post-LASIK ectasia. He had treatment with the classic Dresden epithelium-off technique and presented 4 years later with progression of the ectasia. He was subsequently retreated with conductive keratoplasty (CK) followed by a new proprietary epithelium-on corneal collagen crosslinking (CXL) procedure using a proprietary transepithelial riboflavin formulation and delivery system on the following day. One year after retreatment, the patient noted stable vision in the treated eye with a corrected distance visual acuity (CDVA) of 20/60<sup>+</sup>. Thus, epithelium-on CXL, if performed with appropriate formulations and delivery technology as well as careful attention to appropriate riboflavin loading of the stroma, can stabilize an ectatic cornea. In addition, when performed prior to CXL, CK can induce a significant, lasting improvement in corneal shape and CDVA. This technique merits further study.

Copyright (c) 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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