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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Comparison of the Ratio Between Anterior and Posterior Curvature Centered on the Thinnest Point (A/B Ratio) in Normal and Keratoconus Eyes.

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Updated: Aug 27, 2025

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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EpiSmart Crosslinking for Keratoconus: A Phase 2 Study.

Randy J Epstein1,2, Michael W Belin3,4, Deborah Gravemann5

  • 1Chicago Cornea Consultants, Ltd, Highland Park, IL.

Cornea
|September 29, 2022
PubMed
Summary
This summary is machine-generated.

Epi-on corneal crosslinking improved vision and reduced corneal curvature in keratoconus patients. This safe and effective treatment showed no significant differences between UVA exposure groups.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Vision Science

Background:

  • Keratoconus is a progressive thinning of the cornea leading to irregular astigmatism and vision loss.
  • Corneal crosslinking (CXL) aims to strengthen the cornea and halt keratoconus progression.
  • Epithelium-on (epi-on) CXL offers a potentially less invasive alternative to traditional epithelium-off methods.

Purpose of the Study:

  • To evaluate the efficacy of epithelium-on (epi-on) corneal crosslinking in improving visual acuity in patients diagnosed with keratoconus.
  • To assess changes in corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UCVA) post-treatment.
  • To determine the impact of epi-on CXL on maximum corneal curvature (Kmax) and corneal thickness.

Main Methods:

  • A prospective, randomized, controlled, open-label, multicenter trial enrolled subjects with corneal ectatic diseases.
  • Subjects were randomized into three groups receiving epi-on CXL with varying UVA exposure parameters (2.4 J/cm² for 20 min, 3.6 J/cm² for 20 min, or 3.6 J/cm² for 30 min).
  • Visual acuity (CDVA, UCVA), Kmax, and corneal thickness were assessed at 6 and 12 months post-operatively.

Main Results:

  • Significant improvements in CDVA, UCVA, and Kmax were observed in keratoconus patients at both 6 and 12 months.
  • Corneal thickness remained unchanged post-treatment.
  • The overall incidence of adverse events was 8.7%, with mild corneal epithelial defects in 1.4% of cases; no serious adverse events were reported.

Conclusions:

  • EpiSmart epi-on corneal crosslinking demonstrated significant improvements in visual acuity and corneal curvature in keratoconus patients.
  • The treatment exhibited an excellent safety and efficacy profile with minimal side effects.
  • No significant differences in outcomes were found between the different UVA treatment regimens.