gms | German Medical Science

32. Internationaler Kongress der Deutschen Ophthalmochirurgen (DOC)

23.05. - 25.05.2019, Nürnberg

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Excimer Laser Treatment combined with Riboflavin Ultraviolet-A Collagen Crosslinking in Keratoconus: A Literature Review

Meeting Abstract

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  • Mona Ezzeldin - Universitätsklinikum Düsseldorf, Augenheilkunde, Düsseldorf
  • Filip Filev - Universitätsklinikum Hamburg- Eppendorf, Augenheilkunde, Hamburg
  • Johannes Menzel-Severing - Universitätsklinikum Düsseldorf, Augenheilkunde, Düsseldorf
  • Gerd Geerling - Universitätsklinikum Düsseldorf, Augenheilkunde, Düsseldorf
  • Andreas Frings - Universitätsklinikum Düsseldorf, Augenheilkunde, Düsseldorf
  • Bruce Allan - UCL Institute of Ophthalmology, London, Vereinigtes Königreich

32. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 23.-25.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocPOB 3.1

doi: 10.3205/19doc108, urn:nbn:de:0183-19doc1088

Veröffentlicht: 14. Mai 2019

© 2019 Ezzeldin et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Purpose: To review the clinical outcome of keratoconus patients after Excimer Laser treatment with combined riboflavin UV-A collagen-crosslinking (CXL).

Methods: Following a literature review of studies published in PubMed between 2012 and 2018, peer-reviewed English-written studies were evaluated using the GRADE approach (http://www.gradeworkinggroup.org/). This review focused on changes of the (un)corrected distance visual acuity (UDVA; CDVA), higher order aberrations (HOA) and prevalence of postoperative complications.

Results: Nine studies with a total of 740 eyes were included thereby reporting on 464 eyes with a combined therapy. We found evidence that differences between pre- and postoperative CDVA and UDVA were statistically significant in eight of nine studies after at least 4 months follow-up when CXL was combined with an Excimer Laser treatment compared to CXL alone. Four studies described a statistically significant reduction in HOA, especially coma and spherical aberration. In four studies corneal haze and opacity were reported but successfully treated.

Conclusion: Current studies suggest that CDVA, UDVA and HOA in low to moderate keratoconus patients benefit from a combined treatment without sacrificing biomechanical stability of the cornea. However, long term results are missing as current studies offer follow-up of 56 months or less.