Changes in the biomechanical properties of the human cornea play an important role in the pathogenesis of corneal ectatic diseases. Many different pathological conditions in the cornea may reduce its biomechanical resistance. Corneal collagen cross-linking (CXL) has emerged as a promising technique to slow or even to stop the progression of ectasia. In this procedure, riboflavin (vitamin B2) is administered in conjunction with ultraviolet A light (UVA, 365 nm). This interaction causes the formation of reactive oxygen species, leading to additional covalent bonds between collagen molecules, with consequent biomechanical stiffening of the cornea. Although this method is not yet accepted as an evidence-based treatment of corneal ectasia, the results of prospective, randomised studies of CXL used in the treatment of this pathological entity show significant changes in the properties of corneal tissue. This procedure is currently the only aetiopathogenetic treatment of ectatic eyes that can delay or stop the process of cornea destabilisation, reducing the necessity for keratoplasty. Despite promising results, CXL is associated with issues that include long-term safety and duration of the stabilising effect.
- MeSH
- fotochemoterapie metody MeSH
- fotosenzibilizující látky aplikace a dávkování MeSH
- keratokonus farmakoterapie MeSH
- lidé MeSH
- medicína založená na důkazech MeSH
- reagencia zkříženě vázaná účinky záření MeSH
- riboflavin aplikace a dávkování MeSH
- rohovka účinky léků účinky záření MeSH
- terapie ultrafialovými paprsky metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Corneal cross-linking can halt the progression of keratoconus, but what is the best approach for treatment? There are a number of treatment options for keratoconus, but only corneal cross-linking (CXL) appears to halt the progression of the disease. To guarantee effective cross-linking, CXL treatment involves removal of the corneal epithelium prior to riboflavin application and ultraviolet light illumination - "epi-off" CXL. Several methods of "epi-on" (transepithelial) CXL have been proposed, such as keeping the corneal epithelium intact which should be less painful and help avoid other CXL-associated adverse events. The evidence so far is that epi-off CXL remains the most effective method of strengthening the cornea and slowing keratoconus progression - but transepithelial methods are gaining ground.
- MeSH
- fotochemoterapie metody MeSH
- fotosenzibilizující látky aplikace a dávkování MeSH
- keratokonus patologie terapie MeSH
- kombinovaná terapie metody MeSH
- lidé MeSH
- medicína založená na důkazech MeSH
- reagencia zkříženě vázaná aplikace a dávkování MeSH
- riboflavin aplikace a dávkování MeSH
- rohovkový epitel chirurgie MeSH
- terapie ultrafialovými paprsky metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
