Correlation of Scheimpflug densitometry changes with clinical outcomes after corneal crosslinking

Priya Mathews, Joaquin De Rojas, Patrick B. Rapuano, Christine J. Zemsky, George J. Florakis, Stephen L. Trokel, Leejee H. Suh

Research output: Contribution to journalArticle

Abstract

Purpose: To characterize changes in densitometry after corneal crosslinking (CXL) and correlate it with visual outcomes. Setting: Tertiary referral academic medical center, New York, New York, USA. Design: Retrospective case series. Methods: Patients with progressive keratoconus or post-laser in situ keratomileusis ectasia had CXL following the Dresden protocol. The corrected distance visual acuity (CDVA) and Pentacam imaging were obtained at baseline and follow-up visits. Results: Fifty-seven patients were followed for a mean of 15 months (range 1 to 24 months) after CXL. The CDVA improved significantly from baseline to 6, 12, 18, and 24 months postoperatively. The change in densitometry of the mid-stromal layer, 2.0 to 6.0 mm annulus, at 6 months was correlated with the improvement in CDVA at 6, 12, and 24 months (all P <.10). The increase in densitometry of the mid-stromal layer, centermost 0.0 to 2.0 mm annulus, at 6 months was significantly associated with the decrease in maximum keratometry (K) at 6 and 12 months (both P <.05). Last, the change in densitometry at 6 months was significantly correlated with the decrease in specific higher-order aberrations (HOAs) (P <.05). Conclusions: Although the greatest and most durable post-CXL densitometry change was in the anterior layer, the degree of increased densitometry haze in the mid-stromal layer was most associated with and possibly predictive of improvement in CDVA, maximum K, and HOAs. The persistence of corneal haze at 6 months, measured by increased densitometry, might be a prognostic marker for CXL effectiveness.

Original languageEnglish (US)
Pages (from-to)993-1002
Number of pages10
JournalJournal of Cataract and Refractive Surgery
Volume44
Issue number8
DOIs
StatePublished - Aug 1 2018
Externally publishedYes

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Densitometry
Visual Acuity
Pathologic Dilatations
Keratoconus
Laser In Situ Keratomileusis
Referral and Consultation

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

Mathews, P., De Rojas, J., Rapuano, P. B., Zemsky, C. J., Florakis, G. J., Trokel, S. L., & Suh, L. H. (2018). Correlation of Scheimpflug densitometry changes with clinical outcomes after corneal crosslinking. Journal of Cataract and Refractive Surgery, 44(8), 993-1002. https://doi.org/10.1016/j.jcrs.2018.05.016

Correlation of Scheimpflug densitometry changes with clinical outcomes after corneal crosslinking. / Mathews, Priya; De Rojas, Joaquin; Rapuano, Patrick B.; Zemsky, Christine J.; Florakis, George J.; Trokel, Stephen L.; Suh, Leejee H.

In: Journal of Cataract and Refractive Surgery, Vol. 44, No. 8, 01.08.2018, p. 993-1002.

Research output: Contribution to journalArticle

Mathews, P, De Rojas, J, Rapuano, PB, Zemsky, CJ, Florakis, GJ, Trokel, SL & Suh, LH 2018, 'Correlation of Scheimpflug densitometry changes with clinical outcomes after corneal crosslinking', Journal of Cataract and Refractive Surgery, vol. 44, no. 8, pp. 993-1002. https://doi.org/10.1016/j.jcrs.2018.05.016
Mathews, Priya ; De Rojas, Joaquin ; Rapuano, Patrick B. ; Zemsky, Christine J. ; Florakis, George J. ; Trokel, Stephen L. ; Suh, Leejee H. / Correlation of Scheimpflug densitometry changes with clinical outcomes after corneal crosslinking. In: Journal of Cataract and Refractive Surgery. 2018 ; Vol. 44, No. 8. pp. 993-1002.
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abstract = "Purpose: To characterize changes in densitometry after corneal crosslinking (CXL) and correlate it with visual outcomes. Setting: Tertiary referral academic medical center, New York, New York, USA. Design: Retrospective case series. Methods: Patients with progressive keratoconus or post-laser in situ keratomileusis ectasia had CXL following the Dresden protocol. The corrected distance visual acuity (CDVA) and Pentacam imaging were obtained at baseline and follow-up visits. Results: Fifty-seven patients were followed for a mean of 15 months (range 1 to 24 months) after CXL. The CDVA improved significantly from baseline to 6, 12, 18, and 24 months postoperatively. The change in densitometry of the mid-stromal layer, 2.0 to 6.0 mm annulus, at 6 months was correlated with the improvement in CDVA at 6, 12, and 24 months (all P <.10). The increase in densitometry of the mid-stromal layer, centermost 0.0 to 2.0 mm annulus, at 6 months was significantly associated with the decrease in maximum keratometry (K) at 6 and 12 months (both P <.05). Last, the change in densitometry at 6 months was significantly correlated with the decrease in specific higher-order aberrations (HOAs) (P <.05). Conclusions: Although the greatest and most durable post-CXL densitometry change was in the anterior layer, the degree of increased densitometry haze in the mid-stromal layer was most associated with and possibly predictive of improvement in CDVA, maximum K, and HOAs. The persistence of corneal haze at 6 months, measured by increased densitometry, might be a prognostic marker for CXL effectiveness.",
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AU - Florakis, George J.

AU - Trokel, Stephen L.

AU - Suh, Leejee H.

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