By Ashok Garg
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Extra resources for Mastering Corneal Collagen Cross Linking Techniques
New surgical approaches to the management of keratoconus and post-LASIK ectasia. Trans Am Ophthalmol Soc 2006;104:212-20. 5. Clair-Florent M, Schmitt-Bernard C, Lesage C, Arnaud B. Keratectasia induced by laser in situ keratomileusis in keratoconus. J Refract Surg 2000;16:368-70. 6. Argento C, Cosentino MJ, Tytiun A, et al. Corneal ectasia after laser in situ keratomileusis. J Cataract Refract Surg 2001;27:1440–48. 7. Lafond G, Bazin R, Lajoie C. Bilateral severe keratoconus after laser in situ keratomileusis in a patient with forme fruste keratoconus.
Risks and Side Effects UV light in general represents a potential danger to the human eye. UV-induced photochemical damage like sunburn or photokeratitis, both of which are caused, however, by UV-B light. In the cornea UV-B light (290-320nm) is mainly absorbed by the corneal epithelium. UV-B is also known to mutagenic causing for example, skin cancer. To avoid danger for the endothelium, lens or retina it is mandatory in each patient to perform preoperative pachymetry to exclude extended areas with less than 400 microns stromal thickness, and to check the UV-A irradiance exactly using a UV-A–meter.
13 MASTERING CORNEAL COLLAGEN CROSS-LINKING TECHNIQUES • Patients that have underwent enhancement after LASIK surgery. 23 Enhancement after LASIK surgery may make residual stromal bed thinner. • Asymmetrical cornea steepening. • Asymmetrical astigmatism. 13 • Age: With aging, the structure and shape of the cornea changes and may attribute to the development of ectasia. 24 Clinically, some of the patients who developed corneal ectasia may have multiple risk factors. As technology continually advancing, the knowledge for assessing corneal ectasia following laser in situ keratomileusis continues to grow and criterion may be changed.
Mastering Corneal Collagen Cross Linking Techniques by Ashok Garg