Corneal cross-linking (CXL) combined with refractive surgery for the comprehensive management of keratoconus: CXL plus.

Details

Serval ID
serval:BIB_A3D42B6CD08B
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Corneal cross-linking (CXL) combined with refractive surgery for the comprehensive management of keratoconus: CXL plus.
Journal
Indian journal of ophthalmology
Author(s)
Kankariya V.P., Dube A.B., Grentzelos M.A., Kontadakis G.A., Diakonis V.F., Petrelli M., Kymionis G.D.
ISSN
1998-3689 (Electronic)
ISSN-L
0301-4738
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
68
Number
12
Pages
2757-2772
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
The past two decades have witnessed an unprecedented evolution in the management of keratoconus that demands a holistic approach comprising of inhibiting the ectatic progression as well as visual rehabilitation. The advent of corneal cross-linking (CXL) in the late 1990s resulted in long-term stabilization of the ectatic cornea along with limited reduction in corneal steepening and regularization of corneal curvature. However, CXL as a standalone procedure does not suffice in rehabilitating the functional vision especially in patients who are unwilling or intolerant towards contact lenses. The concept of "CXL plus" was proposed which incorporates adjunctive use of refractive procedures with CXL in order to overcome the optical inefficiency due to corneal irregularity, decrease the irregular astigmatism, correct the residual refractive error and improve functional visual outcome in keratoconus. Several refractive procedures such as conductive keratoplasty (CK), photorefractive keratectomy (PRK), transepithelial phototherapeutic keratectomy (t-PTK), intrastromal corneal ring segments (ICRS) implantation, phakic intraocular lens (PIOL) implantation and multiple other techniques have been combined with CXL to optimize and enhance the CXL outcome. This review aimed to summarize the different protocols of CXL plus, provide guidelines for selection of the optimum CXL plus technique and aid in decision-making for the comprehensive management of cases with primary keratoconus in addition to discussing the future and scope for innovations in the existing treatment protocols.
Keywords
CXL Plus, corneal irregularity, functional vision, keratoconus, refractive
Pubmed
Web of science
Open Access
Yes
Create date
26/11/2020 23:41
Last modification date
14/01/2021 7:22
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