In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus

Riccardo Vinciguerra, Vito Romano, Esmaeil M. Arbabi, Matthias Brunner, Colin Willoughby, Mark Batterbury, Stephen B. Kaye

    Research output: Contribution to journalArticle

    12 Citations (Scopus)

    Abstract

    PURPOSE:To report early corneal biomechanical changes after corneal cross-linking (CXL) in patients with keratoconus.METHODS:Thirty-four eyes of 34 patients undergoing CXL for progressive keratoconus were included in this prospective clinical study. Dynamic corneal response (DCR) parameters obtained with the Corvis ST (OCULUS Optikgeräte GmbH; Wetzlar, Germany) were assessed at baseline (day of CXL) and after 1 month of follow-up; conversely, corneal tomography with the Pentacam (OCULUS Optikgeräte GmbH) was assessed at baseline and at 1, 3, and 6 months after CXL.RESULTS:At the last follow-up visit (123.7 ± 69.6 days), all morphological parameters including steepest point (Kmax) and thinnest corneal thickness (ThCT) indicated stabilization of keratoconus (P > .05). Comparative analyses showed a rise of corneal stiffness demonstrated by a significant increase of Stiffness Parameter A1 (SP-A1) and Highest Concavity (SP-HC) and a significant decrease of Inverse Concave Radius (1/R) and Deformation Amplitude Ratio (DA Ratio) (P <.05). There was a significant correlation between the preoperative keratoconus characteristics (Kmax, Belin/Ambrósio final D value [BAD-D], and ThCT) and the DCR parameters (P <.05). Kmax and BAD-D showed a significant positive correlation with DA Ratio, Deflection Amplitude (DefA), and 1/R and a significant negative correlation with SPA1 and SP-HC. ThCT showed a significant positive correlation with SP-A1 and SP-HC and a significant negative correlation with DA Ratio, DefA, and 1/R.CONCLUSIONS:This study suggests that the new DCR parameters of the Corvis ST are able to detect early changes in biomechanics following CXL and those that are measurable before corneal shape modifications take place. Based on these results, the authors suggest the use of these metrics to assess the early efficacy of cross-linking. [J Refract Surg. 2017;33(12):840-846.].
    LanguageEnglish
    Pages840-846
    JournalJournal of Refractive Surgery
    Volume33
    Issue number12
    DOIs
    Publication statusAccepted/In press - 25 Aug 2017

    Fingerprint

    Keratoconus
    Biomechanical Phenomena
    Germany
    Tomography
    Prospective Studies

    Keywords

    • Biomechanical Phenomena
    • Collagen/metabolism
    • Cornea/physiology*
    • Corneal Topography
    • Cross-Linking Reagents*
    • Keratoconus/drug therapy*
    • Keratoconus/physiopathology
    • Photosensitizing Agents/therapeutic use*
    • Riboflavin/therapeutic use*

    Cite this

    Vinciguerra, Riccardo ; Romano, Vito ; Arbabi, Esmaeil M. ; Brunner, Matthias ; Willoughby, Colin ; Batterbury, Mark ; Kaye, Stephen B. / In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus. In: Journal of Refractive Surgery. 2017 ; Vol. 33, No. 12. pp. 840-846.
    @article{4c792d618fec4e5b8553942620bcc2d5,
    title = "In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus",
    abstract = "PURPOSE:To report early corneal biomechanical changes after corneal cross-linking (CXL) in patients with keratoconus.METHODS:Thirty-four eyes of 34 patients undergoing CXL for progressive keratoconus were included in this prospective clinical study. Dynamic corneal response (DCR) parameters obtained with the Corvis ST (OCULUS Optikger{\"a}te GmbH; Wetzlar, Germany) were assessed at baseline (day of CXL) and after 1 month of follow-up; conversely, corneal tomography with the Pentacam (OCULUS Optikger{\"a}te GmbH) was assessed at baseline and at 1, 3, and 6 months after CXL.RESULTS:At the last follow-up visit (123.7 ± 69.6 days), all morphological parameters including steepest point (Kmax) and thinnest corneal thickness (ThCT) indicated stabilization of keratoconus (P > .05). Comparative analyses showed a rise of corneal stiffness demonstrated by a significant increase of Stiffness Parameter A1 (SP-A1) and Highest Concavity (SP-HC) and a significant decrease of Inverse Concave Radius (1/R) and Deformation Amplitude Ratio (DA Ratio) (P <.05). There was a significant correlation between the preoperative keratoconus characteristics (Kmax, Belin/Ambr{\'o}sio final D value [BAD-D], and ThCT) and the DCR parameters (P <.05). Kmax and BAD-D showed a significant positive correlation with DA Ratio, Deflection Amplitude (DefA), and 1/R and a significant negative correlation with SPA1 and SP-HC. ThCT showed a significant positive correlation with SP-A1 and SP-HC and a significant negative correlation with DA Ratio, DefA, and 1/R.CONCLUSIONS:This study suggests that the new DCR parameters of the Corvis ST are able to detect early changes in biomechanics following CXL and those that are measurable before corneal shape modifications take place. Based on these results, the authors suggest the use of these metrics to assess the early efficacy of cross-linking. [J Refract Surg. 2017;33(12):840-846.].",
    keywords = "Biomechanical Phenomena, Collagen/metabolism, Cornea/physiology*, Corneal Topography, Cross-Linking Reagents*, Keratoconus/drug therapy*, Keratoconus/physiopathology, Photosensitizing Agents/therapeutic use*, Riboflavin/therapeutic use*",
    author = "Riccardo Vinciguerra and Vito Romano and Arbabi, {Esmaeil M.} and Matthias Brunner and Colin Willoughby and Mark Batterbury and Kaye, {Stephen B.}",
    year = "2017",
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    language = "English",
    volume = "33",
    pages = "840--846",
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    In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus. / Vinciguerra, Riccardo; Romano, Vito; Arbabi, Esmaeil M.; Brunner, Matthias; Willoughby, Colin; Batterbury, Mark; Kaye, Stephen B.

    In: Journal of Refractive Surgery, Vol. 33, No. 12, 25.08.2017, p. 840-846.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus

    AU - Vinciguerra, Riccardo

    AU - Romano, Vito

    AU - Arbabi, Esmaeil M.

    AU - Brunner, Matthias

    AU - Willoughby, Colin

    AU - Batterbury, Mark

    AU - Kaye, Stephen B.

    PY - 2017/8/25

    Y1 - 2017/8/25

    N2 - PURPOSE:To report early corneal biomechanical changes after corneal cross-linking (CXL) in patients with keratoconus.METHODS:Thirty-four eyes of 34 patients undergoing CXL for progressive keratoconus were included in this prospective clinical study. Dynamic corneal response (DCR) parameters obtained with the Corvis ST (OCULUS Optikgeräte GmbH; Wetzlar, Germany) were assessed at baseline (day of CXL) and after 1 month of follow-up; conversely, corneal tomography with the Pentacam (OCULUS Optikgeräte GmbH) was assessed at baseline and at 1, 3, and 6 months after CXL.RESULTS:At the last follow-up visit (123.7 ± 69.6 days), all morphological parameters including steepest point (Kmax) and thinnest corneal thickness (ThCT) indicated stabilization of keratoconus (P > .05). Comparative analyses showed a rise of corneal stiffness demonstrated by a significant increase of Stiffness Parameter A1 (SP-A1) and Highest Concavity (SP-HC) and a significant decrease of Inverse Concave Radius (1/R) and Deformation Amplitude Ratio (DA Ratio) (P <.05). There was a significant correlation between the preoperative keratoconus characteristics (Kmax, Belin/Ambrósio final D value [BAD-D], and ThCT) and the DCR parameters (P <.05). Kmax and BAD-D showed a significant positive correlation with DA Ratio, Deflection Amplitude (DefA), and 1/R and a significant negative correlation with SPA1 and SP-HC. ThCT showed a significant positive correlation with SP-A1 and SP-HC and a significant negative correlation with DA Ratio, DefA, and 1/R.CONCLUSIONS:This study suggests that the new DCR parameters of the Corvis ST are able to detect early changes in biomechanics following CXL and those that are measurable before corneal shape modifications take place. Based on these results, the authors suggest the use of these metrics to assess the early efficacy of cross-linking. [J Refract Surg. 2017;33(12):840-846.].

    AB - PURPOSE:To report early corneal biomechanical changes after corneal cross-linking (CXL) in patients with keratoconus.METHODS:Thirty-four eyes of 34 patients undergoing CXL for progressive keratoconus were included in this prospective clinical study. Dynamic corneal response (DCR) parameters obtained with the Corvis ST (OCULUS Optikgeräte GmbH; Wetzlar, Germany) were assessed at baseline (day of CXL) and after 1 month of follow-up; conversely, corneal tomography with the Pentacam (OCULUS Optikgeräte GmbH) was assessed at baseline and at 1, 3, and 6 months after CXL.RESULTS:At the last follow-up visit (123.7 ± 69.6 days), all morphological parameters including steepest point (Kmax) and thinnest corneal thickness (ThCT) indicated stabilization of keratoconus (P > .05). Comparative analyses showed a rise of corneal stiffness demonstrated by a significant increase of Stiffness Parameter A1 (SP-A1) and Highest Concavity (SP-HC) and a significant decrease of Inverse Concave Radius (1/R) and Deformation Amplitude Ratio (DA Ratio) (P <.05). There was a significant correlation between the preoperative keratoconus characteristics (Kmax, Belin/Ambrósio final D value [BAD-D], and ThCT) and the DCR parameters (P <.05). Kmax and BAD-D showed a significant positive correlation with DA Ratio, Deflection Amplitude (DefA), and 1/R and a significant negative correlation with SPA1 and SP-HC. ThCT showed a significant positive correlation with SP-A1 and SP-HC and a significant negative correlation with DA Ratio, DefA, and 1/R.CONCLUSIONS:This study suggests that the new DCR parameters of the Corvis ST are able to detect early changes in biomechanics following CXL and those that are measurable before corneal shape modifications take place. Based on these results, the authors suggest the use of these metrics to assess the early efficacy of cross-linking. [J Refract Surg. 2017;33(12):840-846.].

    KW - Biomechanical Phenomena

    KW - Collagen/metabolism

    KW - Cornea/physiology

    KW - Corneal Topography

    KW - Cross-Linking Reagents

    KW - Keratoconus/drug therapy

    KW - Keratoconus/physiopathology

    KW - Photosensitizing Agents/therapeutic use

    KW - Riboflavin/therapeutic use

    U2 - 10.3928/1081597X-20170922-02

    DO - 10.3928/1081597X-20170922-02

    M3 - Article

    VL - 33

    SP - 840

    EP - 846

    JO - Journal of Refractive Surgery

    T2 - Journal of Refractive Surgery

    JF - Journal of Refractive Surgery

    SN - 1081-597X

    IS - 12

    ER -