Corneal collagen cross-linking with riboflavin and ultraviolet - a light for keratoconus: results in Indian eyes.

AIM: To assess the results of corneal collagen cross-linking with riboflavin using ultraviolet - A light for keratoconus at one year in Indian eyes. MATERIALS AND METHODS: Sixty-eight eyes of 41 patients with progressive keratoconus were included in this retrospective study. All eyes completed was 12 months of follow-up and 37 eyes had a one-year follow-up. The maximum follow-up was 16 months. Ocular examinations including refraction, best corrected visual acuity (BCVA), corneal topography, were recorded at each visit. RESULTS: The mean age was 16.9 +/- 3.5 years (range 12-39 years) and the mean follow-up was 10.05 +/- 3.55 months (range six to 16 months). Thirty seven eyes with a follow-up of at least 12 months were analyzed. The preoperative values on the day of treatment were compared with postoperative values of the 12-month examination. This showed that BCVA improved at least one line in 54% (20/37) of eyes and remained stable in 28% (10/37) of eyes ( P =0.006). Astigmatism decreased by a mean of 1.20 diopter (D) in 47% (17/37) of eyes ( P =0.005) and remained stable (within +/- 0.50 D) in 42% (15/37) of eyes. The K value of the apex decreased by a mean of 2.73 D in 66% (24/37) of eyes ( P =0.004) and remained stable (within +/- 0.50 D) in 22% (8/37) of eyes. The maximum K value decreased by a mean of 2.47 D in 54% (20/37) of eyes ( P =0.004) and remained stable (within +/- 0.50 D) in 38% (14/37) of eyes. Corneal Wavefront analysis revealed that spherical and higher-order aberrations did not show significant variations in the follow-up period. The coma component showed a very significant reduction at six months after treatment and persisted throughout the follow-up period ( P =0.003) CONCLUSION: The results show a stabilization and improvement in keratoconus after collagen cross-linking in Indian eyes. This suggests that it is an effective treatment for progressive keratoconus.

Corneal epithelial wound healing.

One of the important functions of the cornea is to maintain normal vision by refracting light onto the lens and retina. This property is dependent in part on the ability of the corneal epithelium to undergo continuous renewal. Epithelial renewal is essential because it enables this tissue to act as a barrier that protects the corneal interior from becoming infected by noxious environmental agents. The renewal process also maintains the smooth optical surface of the cornea. This rate of renewal is closely maintained by an integrated balance between the processes of corneal epithelial proliferation, differentiation, and cell death. Attempts to understand this complex cascade make it evident that the appropriate integration and coordination of corneal epithelial renewal depends on the actions of a myriad of cytokines. We have attempted in this review to collate the receptor and cell signaling events and cytokine studies that are responsible for mediating corneal wound healing.