Original articleCorneal Healing After Riboflavin Ultraviolet-A Collagen Cross-Linking Determined by Confocal Laser Scanning Microscopy In Vivo: Early and Late Modifications
Section snippets
Methods
Since September 15, 2004, micromorphological examination of 44 cross-linked corneas has been performed at Siena University Ophthalmological Department by Heidelberg Retinal Tomography (HRT) II confocal laser scanning microscopy in vivo (Rostock Cornea Module; Heidelberg Engineering, Heidelberg, Germany). We report confocal analysis of the first 10 Italian patients treated (Siena Eye Cross Project 2004 to 2007)8 three years after the operation. All patients had clinically (uncorrected visual
Limbus
All corneal layers, especially the epithelium, regenerated rapidly (four days) and no damage to the limbal region was observed. Slightly increased reflectivity of extracellular tissue surrounding palisades of Vogt was detected without any pathologic significance and without affecting the germinal epithelium (Figure 1).
Epithelium
In all cases, epithelial regrowth was complete after four days of soft contact lens bandage. No growth retardation or persistent epithelial deficit was detected after corneal
Discussion
Riboflavin UV-A corneal collagen CXL is the only “pathogenetic approach” to progressive keratoconus and post-LASIK corneal ectasia that can delay or block their progression, reducing demand for donor keratoplasty. In vivo confocal study in humans demonstrated early and late modification of corneal microstructure after corneal collagen CXL treatment. The limbal region, where the corneal epithelium joins the conjunctival epithelium, contains a radial arrangement of trabecular conjunctival
Cosimo Mazzotta MD, PhD, graduated from University of Siena, Italy, Medical School in 1997. He has a Specialist diploma in Ophthalmology in 2001 and received his PhD in Ocular Pathology in 2006 from the University of Siena, Italy. With Professor Aldo Caporossi, MD, he introduced the Corneal Cross-Linking in Italy in 2004. Currently, Dr Mazzotta works as a Researcher at the Department Ophthalmology of Siena University and his areas of interest includes keratoconus, corneal dystrophies, and
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2021, Saudi Journal of Biological SciencesCitation Excerpt :Presently, CXL is widely used in treating progressive KC and other corneal ectatic disorders (Belin et al., 2018; Mazzotta et al., 2018). Studies on the human cornea have shown that CXL treatment restores epithelial and anterior stromal keratocytes and enhances the architecture of CFs and flattens undulating lamellae (Akhtar et al., 2013; Mazzotta et al., 2008; O'Brart et al., 2015). The accelerated CXL protocol was developed following the photochemical law of reciprocity (also known as the Bunsen–Roscoe law) to reduce treatment time.
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Cosimo Mazzotta MD, PhD, graduated from University of Siena, Italy, Medical School in 1997. He has a Specialist diploma in Ophthalmology in 2001 and received his PhD in Ocular Pathology in 2006 from the University of Siena, Italy. With Professor Aldo Caporossi, MD, he introduced the Corneal Cross-Linking in Italy in 2004. Currently, Dr Mazzotta works as a Researcher at the Department Ophthalmology of Siena University and his areas of interest includes keratoconus, corneal dystrophies, and refractive surgery.