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Identifier |
000417878 |
Title |
Μελέτη της διασύνδεσης του κερατοειδικού κολλαγόνου σε συνδυασμό με την διεπιθηλιακή φωτοθεραπευτική κερατεκτομή για την αντιμετώπιση των εκτατικών παθήσεων του κερατοειδούς |
Alternative Title |
Corneal collagen cross-linking combined with transepithelial phototherapeutic keratectomy for the treatment of corneal ectatic disorders |
Author
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Γρέντζελος, Μιχαήλ Α.
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Thesis advisor
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Σιγανός, Χαράλαμπος
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Reviewer
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Κιμιωνής, Χαράλαμπος
Παλλήκαρης, Ιωάννης
Τσιλιμπάρης, Μιλτιάδης
Δετοράκης, Ευστάθιος
Βελεγράκης, Γεώργιος
Γραβάνης, Αχιλλέας
Θερμού, Κυριακή
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Abstract |
Purpose: Evaluation of effectiveness and safety of a new surgical technique
regarding the combination of transepithelial phototherapeutic keratectomy
and corneal collagen cross-linking, with or without simultaneous conventional
photorefractive keratectomy, for the treatment of keratoconus, the most usual
corneal ectatic disorder.
Methods: Eighty-one patients (97 eyes) with progressive keratoconus
underwent corneal collagen cross-linng wιth riboflavin and ultraviolet A.
Twenty patients (23 eyes) underwent combined transepithelial
phototherapeutic keratectomy and corneal collagen cross-linking (Cretan
protocol), forty-three patients (55 eyes) underwent combined transepithelial
phototherapeutic keratectomy and conventional photorefractive keratectomy
followed simultaneously by corneal collagen cross-linking (Cretan protocol
plus), while 18 patients (19 eyes) underwent corneal collagen cross-linking
with mechanical epithelial debridement (Dresden protocol). Visual, refractive
and topographic outcomes and the endothelial cell density were evaluated
preoperatively and postoperatively.
Results: There were no intraoperative or postoperative complications in any
of the patients (eyes). Stabilization of keratoconus and halt of the progression
of the ectatic disorder was observed in all eyes. In eyes undergone combined
transepithelial phototherapeutic keratectomy and corneal collagen crosslinking,
uncorrected and corrected distance visual acuity, steep and flat
keratometric values, and corneal astigmatism improved significantly
postoperatively. The improvement for each of these parameters was
observed from a different postoperative timepoint to the end of the
postoperative follow-up. Eyes undergone combined transepithelial
phototherapeutic keratectomy and conventional photorefractive keratectomy
followed simultenaously by corneal collagen cross-linking, all of the above
parameters improved significantly postoperatively even from the first
postoperative month. Eyes undergone corneal collagen cross-linking with
mechanical epithelial debridement, even though stabilization of keratoconus
and halt of the progression of the ectatic disorder was observed, however,
none of the above parameters showed significant improvement
8
postoperatively. No endothelial cell density alterations were observed
throughout the follow-up period.
Conclusions: This new combined surgical technique of transepithelial
phototherapeutic keratectomy and corneal collagen cross-linking, with or
without simultaneous conventional photorefractive keratectomy seems to
result not only in corneal stabilization but also in vision improvement of the
patients. Thus, this new combined technique (Cretan protocol) seems to be
an effective and safe alternative treatment for the management of
keratoconus, the most usual corneal ectatic disorder.
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Language |
Greek |
Subject |
CXL |
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Combined technique |
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Conventional photorefractive keratectomy |
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Cornea |
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Corneal cross-linking |
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Cretan protokol |
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Keratoconus |
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PRK |
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PTK |
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T-PTK |
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Εκτατικές παθήσεις κερατοειδούς |
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Κερατοκώνος |
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Πρωτόκολλο της Κρήτης |
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Συμβατική φωτοδιαθλαστική κερατεκτομή |
Issue date |
2018-12-05 |
Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/6/b/9/metadata-dlib-1544623736-156798-18641.tkl
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Views |
467 |