title: Accelerated Corneal Collagen Cross-linking for Postoperative LASIK Ectasia: Two-Year Outcomes.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking for postoperative LASIK ectasia after 2 years.
  
  
  METHODS
  A prospective, single-center case series was performed with patients treated for postoperative LASIK ectasia. All eyes underwent accelerated corneal collagen cross-linking (CCL-Vario Crosslinking; Peschke Meditrade GmbH, Zurich, Switzerland) at 9 mW/cm(2) for 10 minutes. The main outcome measures were changes in uncorrected distance visual acuity, corrected distance visual acuity, central corneal thickness, corneal topography, and endothelial cell density. These parameters were assessed at baseline and at the 6-month and 1- and 2-year follow-up visit.
  
  
  RESULTS
  The study enrolled 40 eyes of 24 patients (15 male and 9 female) with a mean age of 33.8 ± 7.5 years (range: 24 to 52 years) that attained at least 2 years of follow-up. The surgical procedure was uneventful in all cases. All eyes stabilized after treatment without any further signs of progression and no statistically significant changes in the mean uncorrected distance visual acuity (P = .649), corrected distance visual acuity (P = .616), mean keratometry (P =.837), steep keratometry (P = .956), ultrasonic pachymetry (P = .135), slit-scanning pachymetry (P = .276), and endothelial cell density (P = .523). In addition, 72.5% of the patients presented stable or gains of Snellen lines over time.
  
  
  CONCLUSIONS
  Accelerated corneal collagen cross-linking seems to be safe and effective in halting postoperative LASIK ectasia progression after 2 years of follow-up. However, a longer follow-up period with a larger cohort is needed to validate these findings.
authors.forename: Gustavo K
authors.initials: GK
authors.lastname: Marino
authors.forename: Andre A M
authors.initials: AA
authors.lastname: Torricelli
authors.forename: Natalia
authors.initials: N
authors.lastname: Giacomin
authors.forename: Marcony R
authors.initials: MR
authors.lastname: Santhiago
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Espindola
authors.forename: Marcelo V
authors.initials: MV
authors.lastname: Netto
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011183:Postoperative Complications; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin