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Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique

Overview of attention for article published in Clinical Ophthalmology, December 2016
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17 Mendeley
Title
Under-flap stromal bed CXL for early post-LASIK ectasia: a novel treatment technique
Published in
Clinical Ophthalmology, December 2016
DOI 10.2147/opth.s118831
Pubmed ID
Authors

Avi Wallerstein, Eser Adiguzel, Mathieu Gauvin, Nima Mohammad-Shahi, Mark Cohen

Abstract

Collagen cross-linking (CXL) for post-laser-assisted in situ keratomileusis (LASIK) ectasia (PLE) is traditionally performed either epi-on or epi-off on the corneal surface. This study describes a novel technique in treating early PLE with under-flap CXL (ufCXL) to the stromal bed and reports on 6-month outcomes. Case series of seven patients (eight eyes) with topography-diagnosed early PLE treated with ufCXL. Inclusion criteria were early, mild PLE defined as new-onset postoperative manifest refraction cylinder ≤1.50 D, with new topographic inferior steepening consistent with ectasia, uncorrected distance visual acuity (UDVA) of 20/40 or better, and corrected distance visual acuity (CDVA) of 20/25 or better. Existing LASIK flap was lifted, riboflavin was applied directly to the stromal bed, flap was repositioned, and 18 mW/cm(2) ultraviolet light was applied for 3 minutes to the corneal surface. Post-ufCXL manifest refraction, UDVA and CDVA, corneal cylinder, Kmax, and corneal irregularity index were compared with pre-ufCXL measurements. Patients had a pre-ufCXL sphere of 0.09±0.48 D and cylinder of -0.78±0.49 D. At 6 months, post-ufCXL sphere (0.06±0.8 D; P=0.89) and cylinder (-1.09±0.76 D, P=0.26) were unchanged. Cumulative post-ufCXL UDVA was unchanged, achieving 20/20, 20/30, and 20/40 in 25%, 88%, and 88%, respectively, compared with 13%, 63%, and 88% pre-ufCXL (P=0.68). Post-ufCXL CDVA was unchanged (P=0.93) with a gain of one line in two eyes, a loss of one line in one eye, and five eyes unchanged. The efficacy index (P=0.76), safety index (P=0.89), Kmax (P=0.94), and corneal irregularity index (P=0.73) were also unchanged. Preliminary results with ufCXL for early PLE are promising, demonstrating maintenance of visual accuracy, efficacy, safety, Kmax, and cylinder, with much quicker recovery times than surface CXL.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 17 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 4 24%
Other 3 18%
Professor 2 12%
Student > Ph. D. Student 2 12%
Librarian 1 6%
Other 2 12%
Unknown 3 18%
Readers by discipline Count As %
Medicine and Dentistry 11 65%
Agricultural and Biological Sciences 1 6%
Biochemistry, Genetics and Molecular Biology 1 6%
Unknown 4 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 December 2016.
All research outputs
#7,836,237
of 12,488,808 outputs
Outputs from Clinical Ophthalmology
#712
of 1,597 outputs
Outputs of similar age
#196,993
of 358,960 outputs
Outputs of similar age from Clinical Ophthalmology
#24
of 49 outputs
Altmetric has tracked 12,488,808 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,597 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 42nd percentile – i.e., 42% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 358,960 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 49 others from the same source and published within six weeks on either side of this one. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.