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Change in corneal microstructure with rigid gas permeable contact lens use following collagen cross-linking: an in vivo confocal microscopy study.
- Source :
-
The British journal of ophthalmology [Br J Ophthalmol] 2014 Apr; Vol. 98 (4), pp. 442-7. Date of Electronic Publication: 2013 Dec 24. - Publication Year :
- 2014
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Abstract
- Aim: To study corneal microstructural changes with use of rigid gas permeable contact lenses (CLs) in keratoconus patients following collagen cross-linking (CXL).<br />Methods: In a prospective, non-randomised, comparative case series, keratoconus patients with documented progression were offered CXL (365 nm, 3 mW/cm(2), 30 min with 0.1% riboflavin). Patients who refused CXL were fitted with CL and followed up for 6 months (keratoconus (KL)-CL; 25 eyes). Patients who underwent CXL were either fitted with CL 3 months after the procedure (CXL-CL; 26 eyes) or followed up with only spectacle correction (CXL-SL; 21 eyes). Outcome measures of over-refraction and corneal microstructure (confocal microscopy) were evaluated at time of CXL and 1, 2, 3, 4, 6 and 9 months after CXL.<br />Results: There was a myopic shift in over-refraction by 0.37 D in CXL-CL (p=0.00), and 16/26 eyes required prescription of spectacles over CL to provide optimum vision; change in over-refraction was not seen in KC-CL. Patients using CL (CXL-CL and KC-CL) showed evidence of epithelial cell stress with increase in the superficial epithelial cell size and decrease in basal epithelial cell density. They also had a decrease in corneal sub-basal nerve plexus (CSNP) density and branching. Patients using spectacles after CXL showed regeneration of the sub-basal nerve plexus. Stromal keratocyte regeneration was unaffected with CL use.<br />Conclusions: CL use after CXL is associated with a delay in the regeneration of the CSNP and epithelial cell stress.
- Subjects :
- Adolescent
Adult
Cornea innervation
Corneal Stroma metabolism
Eyeglasses
Female
Humans
Intraocular Pressure physiology
Keratoconus drug therapy
Male
Microscopy, Confocal
Nerve Regeneration physiology
Ophthalmic Nerve physiology
Photosensitizing Agents therapeutic use
Prospective Studies
Prosthesis Fitting
Riboflavin therapeutic use
Young Adult
Collagen metabolism
Contact Lenses
Cornea pathology
Cross-Linking Reagents therapeutic use
Keratoconus therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2079
- Volume :
- 98
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The British journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 24368629
- Full Text :
- https://doi.org/10.1136/bjophthalmol-2013-303934