Customized remodeled vision (CuRV) is a new corneal cross-linking protocol for keratoconus, combining a transepithelial approach with customized energy application. Our aim is to follow-up our patients and establish the short-and long-term results of CuRV.
Customized remodeled vision is a protocol for oxygen-boosted, tranespithelial cross-linking, customized to apply higher energy at the apex of the cone, relatively lower to the cone area and none to healthy cornea. Thus CuRV promises to halt keratoconus progression, simultaneously offering potential for relatively good visual rehabilitation.Our primary outcomes involve spectacle-corrected distance visual acuity and changes in corneal topography/tomography and OCT parameters. These parameters include Kmax, thinnest corneal pachymetry, maximal anterior and posterior elevation, the Fourier analysis-derived irregularity index, and demarcation line depth.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Oxygen-boosted, epithelium-on, customized cross-linking. Highest UV-A application is focused on the apex of the cone. The cone area receives a moderate amount of UV-A, while healthy cornea is spared.
Ophthalmica Eye Institute
Thessaloniki, Kalamaria, Greece
Spectacle-corrected distance visual acuity
Measurements will be performed on Early Treatment of Diabetic Retinopathy Study charts in logMAR units
Time frame: 1-3-6 months, 1 year, 2 years
Kmax
Maximal corneal keratometric value measured on Scheimpflung corneal tomography
Time frame: 1-3-6 months, 1 year, 2 years
Demarcation line depth
Measurements will be performed at 1st postoperative month, when the demarcation line is most visible, on anterior segment optical coherence tomography. The measurement will be performed manually on the scan approximating the thinnest corneal location with the device-native caliper set at 1:1μm.
Time frame: 1 month
Thinnest corneal pachymetry
Values as indicated on Scheimpflung corneal tomography device
Time frame: 1-3-6 months, 1 year, 2 years
Maximal anterior & posterior elevation
Values as indicated on the Belin Ambrosio Enhanced Ectasia module of the Scheimpflung tomography device
Time frame: 1-3-6 months, 1 year, 2 years
Fourier analysis-calculated maximum decentration
Values as indicated on the Fourier analysis module of the Scheimpflung tomography device
Time frame: 1-3-6 months, 1 year, 2 years
Regularization index
Regularization index was proposed by Seiler et al. The measurement will be performed using the maximum flattening and steepening on the Comparison display of the Scheimpflung tomography device.
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Time frame: 1-3-6 months, 1 year, 2 years