Rashmi Deshmukh, Eeshita Agarwal, Swapna Shanbhag, Rasik B Vajpayee
{"title":"圆锥角膜合并角膜缘干细胞缺乏症患者胶原交联的疗效。","authors":"Rashmi Deshmukh, Eeshita Agarwal, Swapna Shanbhag, Rasik B Vajpayee","doi":"10.2147/OPTH.S548579","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To analyse the outcomes of collagen crosslinking (CXL) in eyes with progressive keratoconus (KC) and secondary limbal stem cell deficiency (LSCD) caused by vernal keratoconjunctivitis (VKC).</p><p><strong>Methods: </strong>Patients with progressive KC and VKC having co-existent LSCD who underwent CXL from May 2016 to October 2023 were included. Demographic details, clinical and corneal topography data were collected preoperatively, at 1-months, 3-months, 6-months and 1-year. Details of the CXL procedure and early postoperative complications were noted. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and topographic indices including flattest keratometry (K1), steepest keratometry (K2), mean keratometry (Km), maximum keratometry (Kmax) and thinnest corneal thickness (TCT) were noted at 1-year and compared with the preoperative data.</p><p><strong>Results: </strong>Fifteen eyes of 11 patients were included in the study. Partial LSCD was present in 14 eyes and underwent epithelium-off CXL and 1 eye with total LSCD underwent transepithelial CXL. The mean logarithm of the minimum angle of resolution (logMAR) UCVA pre-CXL was 0.67±0.38 which improved to 0.54±0.32 at 6-months (p=0.05) and 0.65±0.35 logMAR at 1-year post-CXL (p = 0.005). Pre-CXL Km was 53.5±4.77 (median-51.95D) which decreased to post-cxl value of 51.72±3.65 at 6-months (p=0.014) and 52.34±3.83 (median-51.3D) at 1-year (p=0.09). Kmax reduced from 63.41±7.11 (median-63.7D) pre-CXL to 60.65±5.31 (median-59.6) (p=0.05) at 6-months and 61.4±6.01 (median-61.9D) at 1-year post-CXL (p=0.115). Of the 14 eyes that underwent epi-off CXL, 2 eyes (14.28%) had persistent epithelial defects (PEDs), one of which needed amniotic membrane graft (AMG).</p><p><strong>Conclusion: </strong>In our series, most eyes with keratoconus having co-existent LSCD had uncomplicated ocular surface healing post-CXL and remained stable at 1-year with significant improvement in visual acuity. Our study shows that CXL can be successfully performed in cases of Keratoconus with co-existing LSCD without any serious complications.</p>","PeriodicalId":93945,"journal":{"name":"Clinical ophthalmology (Auckland, N.Z.)","volume":"19 ","pages":"3357-3362"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439834/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Collagen Crosslinking in Patients with Keratoconus and Co-Existent Limbal Stem Cell Deficiency.\",\"authors\":\"Rashmi Deshmukh, Eeshita Agarwal, Swapna Shanbhag, Rasik B Vajpayee\",\"doi\":\"10.2147/OPTH.S548579\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To analyse the outcomes of collagen crosslinking (CXL) in eyes with progressive keratoconus (KC) and secondary limbal stem cell deficiency (LSCD) caused by vernal keratoconjunctivitis (VKC).</p><p><strong>Methods: </strong>Patients with progressive KC and VKC having co-existent LSCD who underwent CXL from May 2016 to October 2023 were included. Demographic details, clinical and corneal topography data were collected preoperatively, at 1-months, 3-months, 6-months and 1-year. Details of the CXL procedure and early postoperative complications were noted. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and topographic indices including flattest keratometry (K1), steepest keratometry (K2), mean keratometry (Km), maximum keratometry (Kmax) and thinnest corneal thickness (TCT) were noted at 1-year and compared with the preoperative data.</p><p><strong>Results: </strong>Fifteen eyes of 11 patients were included in the study. Partial LSCD was present in 14 eyes and underwent epithelium-off CXL and 1 eye with total LSCD underwent transepithelial CXL. The mean logarithm of the minimum angle of resolution (logMAR) UCVA pre-CXL was 0.67±0.38 which improved to 0.54±0.32 at 6-months (p=0.05) and 0.65±0.35 logMAR at 1-year post-CXL (p = 0.005). Pre-CXL Km was 53.5±4.77 (median-51.95D) which decreased to post-cxl value of 51.72±3.65 at 6-months (p=0.014) and 52.34±3.83 (median-51.3D) at 1-year (p=0.09). Kmax reduced from 63.41±7.11 (median-63.7D) pre-CXL to 60.65±5.31 (median-59.6) (p=0.05) at 6-months and 61.4±6.01 (median-61.9D) at 1-year post-CXL (p=0.115). Of the 14 eyes that underwent epi-off CXL, 2 eyes (14.28%) had persistent epithelial defects (PEDs), one of which needed amniotic membrane graft (AMG).</p><p><strong>Conclusion: </strong>In our series, most eyes with keratoconus having co-existent LSCD had uncomplicated ocular surface healing post-CXL and remained stable at 1-year with significant improvement in visual acuity. Our study shows that CXL can be successfully performed in cases of Keratoconus with co-existing LSCD without any serious complications.</p>\",\"PeriodicalId\":93945,\"journal\":{\"name\":\"Clinical ophthalmology (Auckland, N.Z.)\",\"volume\":\"19 \",\"pages\":\"3357-3362\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439834/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical ophthalmology (Auckland, N.Z.)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/OPTH.S548579\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical ophthalmology (Auckland, N.Z.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/OPTH.S548579","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Outcomes of Collagen Crosslinking in Patients with Keratoconus and Co-Existent Limbal Stem Cell Deficiency.
Purpose: To analyse the outcomes of collagen crosslinking (CXL) in eyes with progressive keratoconus (KC) and secondary limbal stem cell deficiency (LSCD) caused by vernal keratoconjunctivitis (VKC).
Methods: Patients with progressive KC and VKC having co-existent LSCD who underwent CXL from May 2016 to October 2023 were included. Demographic details, clinical and corneal topography data were collected preoperatively, at 1-months, 3-months, 6-months and 1-year. Details of the CXL procedure and early postoperative complications were noted. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) and topographic indices including flattest keratometry (K1), steepest keratometry (K2), mean keratometry (Km), maximum keratometry (Kmax) and thinnest corneal thickness (TCT) were noted at 1-year and compared with the preoperative data.
Results: Fifteen eyes of 11 patients were included in the study. Partial LSCD was present in 14 eyes and underwent epithelium-off CXL and 1 eye with total LSCD underwent transepithelial CXL. The mean logarithm of the minimum angle of resolution (logMAR) UCVA pre-CXL was 0.67±0.38 which improved to 0.54±0.32 at 6-months (p=0.05) and 0.65±0.35 logMAR at 1-year post-CXL (p = 0.005). Pre-CXL Km was 53.5±4.77 (median-51.95D) which decreased to post-cxl value of 51.72±3.65 at 6-months (p=0.014) and 52.34±3.83 (median-51.3D) at 1-year (p=0.09). Kmax reduced from 63.41±7.11 (median-63.7D) pre-CXL to 60.65±5.31 (median-59.6) (p=0.05) at 6-months and 61.4±6.01 (median-61.9D) at 1-year post-CXL (p=0.115). Of the 14 eyes that underwent epi-off CXL, 2 eyes (14.28%) had persistent epithelial defects (PEDs), one of which needed amniotic membrane graft (AMG).
Conclusion: In our series, most eyes with keratoconus having co-existent LSCD had uncomplicated ocular surface healing post-CXL and remained stable at 1-year with significant improvement in visual acuity. Our study shows that CXL can be successfully performed in cases of Keratoconus with co-existing LSCD without any serious complications.
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