.: ORİJİNAL ARAŞTIRMA
Epithelial Thickness Profile Change After Corneal Crosslinking: A Retrospective Research
Korneal Çapraz Bağlama Tedavisi Sonrası Epitel Kalınlığın Değişimi: Retrospektif Bir Araştırma
Turkiye Klinikleri J Ophthalmol. 2021;30(4):211-7
doi: 10.5336/ophthal.2020-80945
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To assess the corneal epithelial remodeling after corneal crosslinking (CXL) and to investigate the relation between topographic parameters and epithelial thickness change. Material and Methods: Sixty-three eyes of 43 keratoconus patients were included in this retrospective study. Keratometry (K) and elevation data were assessed by Scheimpflug topography and corneal and epithelial thickness profile was obtained by anterior segment spectral-domain optical coherence tomography pre-operatively and at the 1st, 6th and 12th months after CXL. Results: Significant decreases were observed in mean K (p=0.014), maximum K (p=0.049), and mean central corneal thickness (p<0.007) after CXL. Superior corneal epithelial thickness was significantly thinner (p<0.001) and the difference between the minimum and maximum epithelial thickness was less at the post-operative first month and didn't change significantly afterwards. Standard deviation of epithelial thickness across the central 5 mm region statistically decreased in the follow-up period (p=0.008). Conclusion: Significant regularization of the epithelial thickness profile was seen in one year after epithelium-off CXL. Demonstrating the normalization of the corneal epithelium and understanding its impact on the post-operative healing process might contribute to the optimization of treatment protocols.
Keywords: Cross-linking, cornea; keratoconus; epithelium, cornea; tomography, optical coherence
Objective: To assess the corneal epithelial remodeling after corneal crosslinking (CXL) and to investigate the relation between topographic parameters and epithelial thickness change. Material and Methods: Sixty-three eyes of 43 keratoconus patients were included in this retrospective study. Keratometry (K) and elevation data were assessed by Scheimpflug topography and corneal and epithelial thickness profile was obtained by anterior segment spectral-domain optical coherence tomography pre-operatively and at the 1st, 6th and 12th months after CXL. Results: Significant decreases were observed in mean K (p=0.014), maximum K (p=0.049), and mean central corneal thickness (p<0.007) after CXL. Superior corneal epithelial thickness was significantly thinner (p<0.001) and the difference between the minimum and maximum epithelial thickness was less at the post-operative first month and didn't change significantly afterwards. Standard deviation of epithelial thickness across the central 5 mm region statistically decreased in the follow-up period (p=0.008). Conclusion: Significant regularization of the epithelial thickness profile was seen in one year after epithelium-off CXL. Demonstrating the normalization of the corneal epithelium and understanding its impact on the post-operative healing process might contribute to the optimization of treatment protocols.
Keywords: Cross-linking, cornea; keratoconus; epithelium, cornea; tomography, optical coherence
ÖZET
Amaç: Çalışmanın amacı, korneal çapraz bağlama sonrası epitelyal yeniden düzenlenmenin topografik veriler ışığında incelenmesidir. Gereç ve Yöntemler: Kırk üç keratokonus hastasının 63 gözü, bu retrospektif çalışmaya dâhil edilmiştir. Korneal çapraz bağlama tedavisi öncesi ve tedavi sonrası 1, 6 ve 12. aylarda keratometri (K) değerleri ve korneal topografi, Scheimpflug topografi ile değerlendirilirken, kornea epitel kalınlığı, ön segment optik koherens tomografi ile değerlendirilmiştir. Bulgular: Korneal çapraz bağlama tedavisi sonrası ortalama santral kornea kalınlığında (p<0,007), ortalama K değerinde (p=0,014) ve maksimum K değerinde (p=0,049) istatistiksel anlamlı azalma izlendi. Korneal çapraz bağlama tedavisinden 1 ay sonra superior korneal epitel kalınlığı, istatistiksel anlamlı olarak daha ince (p<0,001); maksimum ve minimum korneal epitel kalınlığı arasındaki fark daha az idi, takip boyunca değişim olmadı. Korneal çapraz bağlama tedavisi sonrasındaki takip süresince santral 5 mm kornea alanındaki epitel kalınlığının standart sapması, istatistiksel anlamlı olarak daha az idi (p=0,008). Sonuç: Korneal çapraz bağlama tedavisinden 1 yıl sonra, korneal epitel kalınlığında anlamlı bir düzgünleşme izlendi. Korneal epitelin iyileşme sürecinin daha iyi değerlendirilmesi ve korneal çapraz bağlama sonrası iyileşme sürecinin anlaşılması, daha verimli tedavi protokollerinin geliştirilmesine yardımcı olacaktır.
Anahtar Kelimeler: Çapraz bağlama, kornea; keratokonus; epitelyum, kornea; tomografi, optik koherens
Amaç: Çalışmanın amacı, korneal çapraz bağlama sonrası epitelyal yeniden düzenlenmenin topografik veriler ışığında incelenmesidir. Gereç ve Yöntemler: Kırk üç keratokonus hastasının 63 gözü, bu retrospektif çalışmaya dâhil edilmiştir. Korneal çapraz bağlama tedavisi öncesi ve tedavi sonrası 1, 6 ve 12. aylarda keratometri (K) değerleri ve korneal topografi, Scheimpflug topografi ile değerlendirilirken, kornea epitel kalınlığı, ön segment optik koherens tomografi ile değerlendirilmiştir. Bulgular: Korneal çapraz bağlama tedavisi sonrası ortalama santral kornea kalınlığında (p<0,007), ortalama K değerinde (p=0,014) ve maksimum K değerinde (p=0,049) istatistiksel anlamlı azalma izlendi. Korneal çapraz bağlama tedavisinden 1 ay sonra superior korneal epitel kalınlığı, istatistiksel anlamlı olarak daha ince (p<0,001); maksimum ve minimum korneal epitel kalınlığı arasındaki fark daha az idi, takip boyunca değişim olmadı. Korneal çapraz bağlama tedavisi sonrasındaki takip süresince santral 5 mm kornea alanındaki epitel kalınlığının standart sapması, istatistiksel anlamlı olarak daha az idi (p=0,008). Sonuç: Korneal çapraz bağlama tedavisinden 1 yıl sonra, korneal epitel kalınlığında anlamlı bir düzgünleşme izlendi. Korneal epitelin iyileşme sürecinin daha iyi değerlendirilmesi ve korneal çapraz bağlama sonrası iyileşme sürecinin anlaşılması, daha verimli tedavi protokollerinin geliştirilmesine yardımcı olacaktır.
Anahtar Kelimeler: Çapraz bağlama, kornea; keratokonus; epitelyum, kornea; tomografi, optik koherens
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