Corneal cross-linking w leczeniu stożka rogówki – 3-letnie obserwacje własne
Corneal Cross-Linking in Keratoconus Treatment – 3 Years of Own Experience
Justyna Izdebska1,3, Iwona Liberek2,3, Jerzy Szaflik1,3
1 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik: dr hab. n. med. Iwona Grabska-Liberek
3 Centrum Mikrochirurgii Oka LASER w Warszawie
Summary: Purpose: Evaluation of efficancy, stability, and safety of Corneal Cross-Linking (CXL).
Patients and Methods: In 155 eyes (103 patients) CXL was performed in Microsurgery Eye Center LASER Warsaw Poland between January 2007 and 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, 24 and 36 months. The complications of the procedure were also assessed.
Results: UCVA and BCVA were improved. BCVA improved >1 line in 74.8% (116 eyes), in 5 cases was worse at the early post-operative period. There was a further improvement of UCVA and BCVA in long term observation. K max values were lower (mean 1.40 D) in all cases during whole period. No progression of keratoconus was observed after 3 years. There were no significant changes in pachymetry and IOP. The clinically significant stromal haze was observed in 139 cases (89.7%) during first 3 months after CXL.
Conclusions: The Corneal Cross-Linking is an effective method of stabilizations of progressive keratoconus in three years observations. The method is safe and well tolerated by patients. CXL doesn’t exclude the possibility to perform other procedures for such patients in the future.
Słowa kluczowe: Corneal cross-linking, stożek rogówki.
Keywords: Corneal Cross-Linking, keratoconus.