دورية أكاديمية
Prospective Objective Analysis of Corneal Haze Following Customized Transepithelial PRK Without Mitomycin C Combined With Accelerated Corneal Cross-Linking Versus Corneal Cross-Linking Alone.
| العنوان: | Prospective Objective Analysis of Corneal Haze Following Customized Transepithelial PRK Without Mitomycin C Combined With Accelerated Corneal Cross-Linking Versus Corneal Cross-Linking Alone. |
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| المؤلفون: | Awwad ST, Bteich Y, Assaf JF, Ghosn A, Hafezi F, Torres-Netto E, Chacra LM, Kozhaya K |
| المصدر: | Journal of refractive surgery (Thorofare, N.J. : 1995) [J Refract Surg] 2024 Sep; Vol. 40 (9), pp. e583-e594. Date of Electronic Publication: 2024 Sep 01. |
| نوع المنشور: | Journal Article; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: SLACK Inc Country of Publication: United States NLM ID: 9505927 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-2391 (Electronic) Linking ISSN: 1081597X NLM ISO Abbreviation: J Refract Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Thorofare, NJ : SLACK Inc., c1995- |
| مواضيع طبية MeSH: | Photorefractive Keratectomy*/methods , Cross-Linking Reagents*/therapeutic use , Visual Acuity*/physiology , Photosensitizing Agents*/therapeutic use , Mitomycin*/administration & dosage , Refraction, Ocular*/physiology , Keratoconus*/drug therapy , Keratoconus*/physiopathology , Keratoconus*/metabolism , Riboflavin*/therapeutic use , Lasers, Excimer*/therapeutic use , Corneal Stroma*/metabolism , Photochemotherapy*/methods , Corneal Opacity*/physiopathology , Corneal Opacity*/etiology , Tomography, Optical Coherence* , Collagen*/metabolism , Corneal Topography*, Humans ; Prospective Studies ; Female ; Male ; Adult ; Young Adult ; Ultraviolet Rays ; Combined Modality Therapy ; Corneal Cross-Linking |
| مستخلص: | Purpose: To compare haze and refractive outcomes in patients undergoing combined accelerated corneal cross-linking (A-CXL) and selective wavefront-guided transepithelial photorefractive keratectomy (WG-transPRK) without mitomycin C (MMC) versus those undergoing A-CXL. Methods: This prospective study analyzed 95 eyes (86 patients) with progressive keratoconus from October 2018 to October 2022. The first group underwent CXL combined with corneal or ocular WG-transPRK (CXL+PRK, n = 52), targeting higher order aberrations (HOAs). The second underwent CXL only (n = 43), both following the same accelerated CXL protocol without MMC on the SCHWIND Amaris laser platform (SCHWIND eye-tech-solutions). Baseline and postoperative evaluations (1, 3, 6, and 12 months) included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, tomography, corneal HOAs, and optical coherence tomography (OCT) scans. A patented machine learning algorithm objectively detected and quantified stromal haze on OCT scans in grayscale units. Results: In both groups, anterior corneal haze reflectivity and subepithelial haze peaked at 3 months postoperatively, then progressively decreased at 6 and 12 months. Haze did not differ between groups at any time point. By 12 months, CDVA increased by 2.5 lines in the CXL+PRK group ( P < .001) and by 0.7 lines in the CXL group ( P = .10), and maximum keratometry decreased from 51.70 ± 5.10 to 47.90 ± 7.90 diopters (D) (CXL+PRK group) ( P < .001) and from 51.20 ± 5.10 to 50.30 ± 4.60 D (CXL group) ( P = .004). Corneal HOAs decreased in both groups but more in the CXL+PRK group. Conclusions: Combining CXL with WG-transPRK without MMC does not result in increased haze when compared to A-CXL alone. This combined approach achieves greater improvements in visual, topographic, and aberrometric parameters. [ J Refract Surg . 2024;40(9):e583-e594.] . |
| المشرفين على المادة: | 0 (Cross-Linking Reagents) 0 (Photosensitizing Agents) 50SG953SK6 (Mitomycin) TLM2976OFR (Riboflavin) 9007-34-5 (Collagen) |
| تواريخ الأحداث: | Date Created: 20240910 Date Completed: 20240910 Latest Revision: 20240910 |
| رمز التحديث: | 20240910 |
| DOI: | 10.3928/1081597X-20240715-03 |
| PMID: | 39254239 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1938-2391 |
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| DOI: | 10.3928/1081597X-20240715-03 |