.: OKULISTYKA :.

Wydanie 2/2009
str. 68

Zastosowanie metody cross-linking w leczeniu stożka rogówki - obserwacje własne

Corneal Cross-Linking in Keratoconus Treatment - Own Experience

Justyna Izdebska^1,3, Iwona Grabska-Liberek^2,3, Jerzy Szaflik^1,3

¹Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
²Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik: dr hab. n. med. Iwona Grabska-Liberek
³Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik

Summary: Corneal Cross-Linking. Topical treatment with ryboflavin and exposure to ultraviolet A (365 nm) light consists in the photopolymerization of the stromal collagen fibers with the intent of increasing rigidity of the cornea and resistance to keratectasia. The treatment was originally introduced in Germany during the mid ?90 s by group of researches of the Technicak University of Dresden by Gregor Wollensak, Theo Seiler and Eberhard Spoerl with the objective to slow down or arrest the progression of keratoconus and thus to avoid or at least to delay the necessity of keratoplasty Purpose: To evaluate predictability, stability, and safety of Corneal Cross Linking (CXL). Patients and Methods: In 152 eyes (108 patients) CxL was performed in Microsurgery Eye Center LASER Warsaw Poland between January 2007and April 2008. The progresive keratoconus at 1 or 2 degree without scars was diagnosed in all eyes. Procedure was done under topical anesthesia. After corneal deepithelization (diameter 9 mm) and instillation of riboflavin phosphate 20% dextran T 500 solution every 5 minutes for 30 minutes. UVA radiation (energy 3 mW/ cm2) was applied for 30 minutes. The following parameters was analyzed: UCVA, BCVA, mean K, pachymetry, IOP at 1, 6, 12 months. The complications of the procedure were also assessed. Results: UCVA and BCVA were improved (>1 line) in 76.3% (116 eyes), in 5 cases was worse at the post operative period. Kmax values were lower (mean 1.4 D) in all cases during whole period. No progression of keratoconus was observed after 1 year. There was no changes in pachymetry and IOP. The clinically significant stromal haze was observed in 136 (89.5%) cases during first 3 months after CxL. Conclusions: The Corneal Cross Linking ( CXL) is an effective method for stabilizations of progressive keratoconus. The method is safe with good tolerance by patients. CxL doesn?t exclude the possibility to perform other procedures for such patients in the future.

Słowa kluczowe: stożek rogówki, metoda corneal cross-linking.

Keywords: keratoconus, Corneal Cross-Linking.

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