title: Corneal collagen crosslinking for ectasia after laser in situ keratomileusis: long-term results.
abstract: OBJECTIVE
  To report the long-term results of corneal collagen crosslinking (CXL) treatment for post-laser in situ keratomileusis (LASIK) ectasia.
  
  
  METHODS
  Turkiye Hospital Eye Clinic and Fatih University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey.
  
  
  METHODS
  Retrospective case series study.
  
  
  METHODS
  Consecutive patients with ectasia after LASIK were treated with CXL. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical and cylindrical refractions, and simulated keratometry (K) values.
  
  
  RESULTS
  The study enrolled 20 eyes (14 patients; 7 women) with a mean age of 34.8 years ± 6.0 (SD) (range 25 to 45 years) and mean follow-up of 42 months (range 36 to 60 months). The UDVA and CDVA improved significantly, from 0.78 ± 0.61 logMAR to 0.53 ± 0.36 logMAR (P=.007) and from 0.27 ± 0.23 logMAR to 0.19 ± 0.13 logMAR, respectively (P≤.028). No eye lost 1 or more Snellen lines of UDVA or CDVA. Although the mean spherical refraction was not significantly different at the last visit (P=.074), the mean cylindrical refraction decreased significantly (P=.036). The maximum K value decreased from 46.0 ± 4.4 diopters (D) at baseline to 45.6 ± 3.8 D at the last visit (P=.013). By the last visit, the maximum K value decreased (≥1.0 D) in 5 eyes and remained stable in 15 eyes. No serious complications occurred.
  
  
  CONCLUSIONS
  Corneal collagen crosslinking yielded long-term stability in cases with post-LASIK corneal ectasia without significant side effects. Improvements in visual acuity, cylindrical refraction, and maximum K values occurred.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey. Electronic address: drayldrm@yandex.com.
authors.forename: Aydin
authors.initials: A
authors.lastname: Yildirim
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Hanefi
authors.initials: H
authors.lastname: Cakir
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Necip
authors.initials: N
authors.lastname: Kara
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Hasim
authors.initials: H
authors.lastname: Uslu
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Gurler
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Engin Bilge
authors.initials: EB
authors.lastname: Ozgurhan
authors.affiliation: From the Departments of Ophthalmology, Fatih University Medical Faculty Hospital (Yildirim, Uslu, Gurler, Colak), Gaziantep Sehitkamil State Hospital (Kara), and Beyoglu Eye Education and Research Hospital (Ozgurhan), and Turkiye Hospital Eye Clinic (Cakir), Istanbul, Turkey.
authors.forename: Hatice Nur
authors.initials: HN
authors.lastname: Colak
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003316:Corneal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011183:Postoperative Complications; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin