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Tytuł:
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Long-term results of combined transepithelial phototherapeutic keratectomy and corneal collagen crosslinking for keratoconus: Cretan protocol.
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Autorzy:
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Kymionis GD; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA. Electronic address: .
Grentzelos MA; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Kankariya VP; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Liakopoulos DA; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Karavitaki AE; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Portaliou DM; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Tsoulnaras KI; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
Pallikaris IG; From the Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Karavitaki, Portaliou, Tsoulnaras, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece and the Bascom Palmer Eye Institute (Kymionis, Portaliou), Miller School of Medicine, University of Miami, Miami, Florida, USA.
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Źródło:
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Journal of cataract and refractive surgery [J Cataract Refract Surg] 2014 Sep; Vol. 40 (9), pp. 1439-45.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 2020- : [Hagerstown, MD] : Wolters Kluwer on behalf of ASCRS and ESCRS
Original Publication: [Fairfax, Va.] : American Society of Cataract and Refractive Surgery, [c1986-
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MeSH Terms:
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Cross-Linking Reagents*
Collagen/*metabolism
Corneal Stroma/*metabolism
Keratoconus/*therapy
Photochemotherapy/*methods
Photorefractive Keratectomy/*methods
Adolescent ; Adult ; Combined Modality Therapy ; Epithelium, Corneal/surgery ; Female ; Follow-Up Studies ; Humans ; Keratoconus/drug therapy ; Keratoconus/metabolism ; Keratoconus/surgery ; Lasers, Excimer/therapeutic use ; Male ; Photosensitizing Agents/therapeutic use ; Prospective Studies ; Refraction, Ocular/physiology ; Riboflavin/therapeutic use ; Ultraviolet Rays ; Visual Acuity/physiology ; Young Adult
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Substance Nomenclature:
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0 (Cross-Linking Reagents)
0 (Photosensitizing Agents)
9007-34-5 (Collagen)
TLM2976OFR (Riboflavin)
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Entry Date(s):
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Date Created: 20140820 Date Completed: 20150821 Latest Revision: 20220408
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Update Code:
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20240104
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DOI:
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10.1016/j.jcrs.2014.01.040
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PMID:
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25135535
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Purpose: To present the long-term results of combined transepithelial phototherapeutic keratectomy (PTK) and corneal collagen crosslinking (CXL) for keratoconus.
Setting: Vardinoyiannion Eye Institute of Crete, University of Crete, Heraklion, Crete, Greece.
Design: Prospective case series.
Methods: Patients with progressive keratoconus had combined transepithelial PTK and CXL (Cretan protocol). Visual and refractive outcomes and the endothelial cell density (ECD) were evaluated preoperatively and postoperatively.
Results: Twenty patients (23 eyes) were enrolled; postoperatively 23 eyes were evaluated at 1 and 2 years, 11 at 3 years, and 7 at 4 years. The mean follow-up was 33.83 months±10.82 (SD) (range 24 to 56 months). No intraoperative or postoperative complications occurred. The mean uncorrected distance visual acuity improved significantly from 0.99±0.57 logMAR preoperatively to 0.61±0.36 logMAR at the last follow-up (P<.001) and the mean corrected distance visual acuity, from 0.27±0.24 logMAR to 0.17±0.14 logMAR (P=.018), respectively. The mean steep and mean flat keratometry readings decreased significantly from 53.39±7.14 diopters (D) and 47.17±4.87 D, respectively, preoperatively to 49.99±4.36 D (P<.001) and 45.47±2.95 D (P=.002), respectively, at the last follow-up. The mean corneal astigmatism improved significantly from -6.27±4.19 D preoperatively to -4.52±2.80 D (P<.001) at the last follow-up. No significant ECD alterations occurred (P>.05).
Conclusion: Combined transepithelial PTK and CXL was effective and safe in keratoconic patients over a long-term follow-up.
Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.
(Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)
