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Conventional and transepithelial corneal cross-linking for patients with keratoconus

Previous studies investigating the effectiveness of conventional corneal collagen cross-linking (CXL) and transepithelial CXL in keratoconus treatment have reported conflicting outcomes. Therefore, we conducted a meta-analysis to compare the effectiveness of these treatments. We searched MEDLINE, EM...

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Autores principales: Zhang, Xiaoyu, Zhao, Jing, Li, Meiyan, Tian, Mi, Shen, Yang, Zhou, Xingtao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886478/
https://www.ncbi.nlm.nih.gov/pubmed/29621306
http://dx.doi.org/10.1371/journal.pone.0195105
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author Zhang, Xiaoyu
Zhao, Jing
Li, Meiyan
Tian, Mi
Shen, Yang
Zhou, Xingtao
author_facet Zhang, Xiaoyu
Zhao, Jing
Li, Meiyan
Tian, Mi
Shen, Yang
Zhou, Xingtao
author_sort Zhang, Xiaoyu
collection PubMed
description Previous studies investigating the effectiveness of conventional corneal collagen cross-linking (CXL) and transepithelial CXL in keratoconus treatment have reported conflicting outcomes. Therefore, we conducted a meta-analysis to compare the effectiveness of these treatments. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for prospective randomized controlled trials (RCTs) with no restrictions. We included visual acuity (corrected distance visual acuity, uncorrected distance visual acuity) and corneal keratometry (K) as primary outcome parameters, and spherical equivalent, central corneal thickness (CCT), and endothelial cell density, as secondary parameters. We finally included seven reports (including six RCTs involving 305 participants and 344 eyes). Our analysis revealed significant postoperative differences in average K and CCT values between conventional and transepithelial CXL-treated patients [K: weighted mean difference (WMD) = 0.79, 95% confidence interval (CI) = 0.04–1.53, p = 0.04; CCT: WMD = 4.53, 95% CI = 0.42–8.64, p = 0.03]. In contrast, we did not find any significant differences in visual acuity, flattest K value, steepest K value, cylinder K value, apex K value, spherical equivalent, or endothelial cell density between groups. In conclusion, transepithelial CXL has a more protective influence on corneal thickness than conventional CXL, and results in lesser postoperative corneal flattening. Further investigation of the clinical outcomes of transepithelial CXL is required.
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spelling pubmed-58864782018-04-20 Conventional and transepithelial corneal cross-linking for patients with keratoconus Zhang, Xiaoyu Zhao, Jing Li, Meiyan Tian, Mi Shen, Yang Zhou, Xingtao PLoS One Research Article Previous studies investigating the effectiveness of conventional corneal collagen cross-linking (CXL) and transepithelial CXL in keratoconus treatment have reported conflicting outcomes. Therefore, we conducted a meta-analysis to compare the effectiveness of these treatments. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for prospective randomized controlled trials (RCTs) with no restrictions. We included visual acuity (corrected distance visual acuity, uncorrected distance visual acuity) and corneal keratometry (K) as primary outcome parameters, and spherical equivalent, central corneal thickness (CCT), and endothelial cell density, as secondary parameters. We finally included seven reports (including six RCTs involving 305 participants and 344 eyes). Our analysis revealed significant postoperative differences in average K and CCT values between conventional and transepithelial CXL-treated patients [K: weighted mean difference (WMD) = 0.79, 95% confidence interval (CI) = 0.04–1.53, p = 0.04; CCT: WMD = 4.53, 95% CI = 0.42–8.64, p = 0.03]. In contrast, we did not find any significant differences in visual acuity, flattest K value, steepest K value, cylinder K value, apex K value, spherical equivalent, or endothelial cell density between groups. In conclusion, transepithelial CXL has a more protective influence on corneal thickness than conventional CXL, and results in lesser postoperative corneal flattening. Further investigation of the clinical outcomes of transepithelial CXL is required. Public Library of Science 2018-04-05 /pmc/articles/PMC5886478/ /pubmed/29621306 http://dx.doi.org/10.1371/journal.pone.0195105 Text en © 2018 Zhang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Zhang, Xiaoyu
Zhao, Jing
Li, Meiyan
Tian, Mi
Shen, Yang
Zhou, Xingtao
Conventional and transepithelial corneal cross-linking for patients with keratoconus
title Conventional and transepithelial corneal cross-linking for patients with keratoconus
title_full Conventional and transepithelial corneal cross-linking for patients with keratoconus
title_fullStr Conventional and transepithelial corneal cross-linking for patients with keratoconus
title_full_unstemmed Conventional and transepithelial corneal cross-linking for patients with keratoconus
title_short Conventional and transepithelial corneal cross-linking for patients with keratoconus
title_sort conventional and transepithelial corneal cross-linking for patients with keratoconus
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886478/
https://www.ncbi.nlm.nih.gov/pubmed/29621306
http://dx.doi.org/10.1371/journal.pone.0195105
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