nach oben

Graefe's Archive for Clinical and Experimental Ophthalmology

Erschienen in:

22.03.2023 | Review Article

Network meta-analysis comparing efficacy and safety of different protocols of corneal cross-linking for the treatment of progressive keratoconus

verfasst von: Lan Ding, Ling Sun, Xingtao Zhou

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 10/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed to determine the preferred protocol of corneal collagen cross-linking (CXL) in the treatment of progressive keratoconus.

Methods

Relevant studies were retrieved in PubMed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL). Maximum keratometry value (K_max), best spectacle-corrected visual acuity (BSCVA), manifest refraction spherical equivalent (MRSE), and endothelial cell density (ECD) were evaluated in network meta-analysis.

Results

Eight randomized controlled trials (RCTs) were included. Low-level evidence suggested that aCXL with 30mW/cm² for 3 min (aCXL-3) might be the best protocol for reducing BSCVA (65.22%) but worst protocol for reducing MRSE (51.53%). aCXL with 18mW/cm² for 5 min (aCXL-5) might be the best protocol for reducing K_max (39.58%) and MRSE (77.85%) but might be the worst for preserving ECD (50.98%). aCXL with 9mW/cm² for 10 min (aCXL-10) might be the best protocol for preserving ECD (31.53%).

Conclusion

Overall, three protocols of aCXL are comparable in therapeutic efficacy and safety for treating progressive keratoconus. Despite no direct data comparing the efficacy of each technique according to different patients' profiles, it is reasonable to state that aCXL-5 may be the best for patients at early-stage to reduce K_max and MRSE, aCXL-3 may be the best for patients at mid-stage to improve BSCVA, and aCXL-10 may be the best for patients at late-stage to preserve DEC.

Nur mit Berechtigung zugänglich

Rabinowitz YS (1998) Keratoconus. Surv Ophthalmol 42:297–319CrossRefPubMed

Hashemi H, Mohebbi M, Asgari S (2020) Standard and accelerated corneal cross-linking long-term results: A randomized clinical trial. Eur J Ophthalmol 30:650–657. https://doi.org/10.1177/1120672119839927CrossRefPubMed

Wollensak G, Spoerl E, Seiler T (2003) Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 135:620–627. https://doi.org/10.1016/s0002-9394(02)02220-1CrossRefPubMed

Cantemir A, Alexa AI, Galan BG et al (2017) Iontophoretic collagen cross-linking versus epithelium-off collagen cross-linking for early stage of progressive keratoconus – 3years follow-up study. Acta Ophthalmol 95:e649–e655CrossRefPubMed

Wittig-Silva C, Franzco EC, Islam FMA et al (2014) A Randomized, Controlled Trial of Corneal Collagen Cross-Linking in Progressive Keratoconus. Ophthalmology 121:812–821CrossRefPubMed

Hashemi H, Seyedian MA, Miraftab M et al (2013) Corneal collagen cross-linking with riboflavin and ultraviolet a irradiation for keratoconus: long-term results. Ophthalmology 120:1515–1520CrossRefPubMed

O’Brart D, Kwong T, Patel P et al (2013) Long-term follow-up of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linking to halt the progression of keratoconus. Br J Ophthalmol 97:433–437. https://doi.org/10.1136/bjophthalmol-2012-302556CrossRefPubMed

Wen D, Li Q, Song B et al (2018) Comparison of Standard Versus Accelerated Corneal Collagen Cross-Linking for Keratoconus: A Meta-Analysis. Invest Ophthalmol Vis Sci 59:3920–3931. https://doi.org/10.1167/iovs.18-24656CrossRefPubMed

Waszczykowska A, Jurowski P (2015) Two-year accelerated corneal cross-linking outcome in patients with progressive keratoconus. BioMed Res Int 2015:325157. https://doi.org/10.1155/2015/325157CrossRefPubMedPubMedCentral

10.

Kymionis GD, Tsoulnaras KI, Liakopoulos DA et al (2016) Corneal Stromal Demarcation Line Depth Following Standard and a Modified High Intensity Corneal Cross-linking Protocol. J Refract Surg 32:218–222CrossRefPubMed

11.

Razmjoo H, Peyman A, Rahimi A et al (2017) Cornea Collagen Cross-linking for Keratoconus: A Comparison between Accelerated and Conventional Methods. Adv Biomed Res 6:10. https://doi.org/10.4103/2277-9175.200785CrossRefPubMedPubMedCentral

12.

Kobashi H, Tsubota K (2020) Accelerated Versus Standard Corneal Cross-Linking for Progressive Keratoconus: A Meta-Analysis of Randomized Controlled Trials. Cornea 39:172–180. https://doi.org/10.1097/ico.0000000000002092CrossRefPubMed

13.

Shajari M, Kolb CM, Agha B et al (2019) Comparison of standard and accelerated corneal cross-linking for the treatment of keratoconus: a meta-analysis. Acta Ophthalmol 97:e22–e35. https://doi.org/10.1111/aos.13814CrossRefPubMed

14.

Schindl A, Rosado-Schlosser B, Trautinger F (2001) Reciprocity regulation in photobiology. An overview. Hautarzt 52:779–785. https://doi.org/10.1007/s001050170065CrossRefPubMed

15.

Lang PZ, Hafezi NL, Khandelwal SS et al (2019) Comparative Functional Outcomes After Corneal Crosslinking Using Standard, Accelerated, and Accelerated With Higher Total Fluence Protocols. Cornea 38:433–441. https://doi.org/10.1097/ico.0000000000001878CrossRefPubMed

16.

Shetty R, Pahuja NK, Nuijts RM et al (2015) Current Protocols of Corneal Collagen Cross-Linking: Visual, Refractive, and Tomographic Outcomes. Am J Ophthalmol 160:243–249. https://doi.org/10.1016/j.ajo.2015.05.019CrossRefPubMed

17.

Hoaglin DC, Hawkins N, Jansen JP et al (2011) Conducting indirect-treatment-comparison and network-meta-analysis studies: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 2. Value Health J Int Soc Pharmacoecon Outcomes Res 14:429–437CrossRef

18.

Page MJ, Moher D, Bossuyt PM et al (2021) PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ (Clin Res Ed) 372:n160. https://doi.org/10.1136/bmj.n160CrossRef

19.

Hutton B, Salanti G, Caldwell DM et al (2015) The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 162:777–784. https://doi.org/10.7326/m14-2385CrossRefPubMed

20.

Jansen JP, Fleurence R, Devine B et al (2011) Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1. Value in Health 14:417–428CrossRefPubMed

21.

Higgins JPT, Altman DG, Gøtzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clin Res Ed) 343:d5928–d5928. https://doi.org/10.1136/bmj.d5928CrossRef

22.

Cipriani A, Higgins JPT, Geddes JR et al (2013) Conceptual and technical challenges in network meta-analysis. Ann Intern Med 159:130–137. https://doi.org/10.7326/0003-4819-159-2-201307160-00008CrossRefPubMed

23.

Brooks S, Gelman A (1998) General Methods for Monitoring Convergence of Iterative Simulations. J Comput Graphi Stat 7:434–455. https://doi.org/10.1080/10618600.1998.10474787CrossRef

24.

Burger DA, Schall R (2015) A Bayesian Nonlinear Mixed-Effects Regression Model for the Characterization of Early Bactericidal Activity of Tuberculosis Drugs. J Biopharm Stat 25:1247–1271. https://doi.org/10.1080/10543406.2014.971170CrossRefPubMed

25.

Singh S, Murad MH, Chandar AK et al (2015) Comparative Effectiveness of Pharmacological Interventions for Severe Alcoholic Hepatitis: A Systematic Review and Network Meta-analysis. Gastroenterology 149:958-970.e912. https://doi.org/10.1053/j.gastro.2015.06.006CrossRefPubMed

26.

Bowden J, Tierney JF, Copas AJ et al (2011) Quantifying, displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised Q statistics. BMC Med Res Methodol 11:41. https://doi.org/10.1186/1471-2288-11-41CrossRefPubMedPubMedCentral

27.

Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558. https://doi.org/10.1002/sim.1186CrossRefPubMed

28.

Dias S, Welton NJ, Caldwell DM et al (2010) Checking consistency in mixed treatment comparison meta-analysis. Stat Med 29:932–944CrossRefPubMed

29.

Palma Perez S, Delgado Rodriguez M (2006) Practical considerations on detection of publication bias. Gac Sanit 20(Suppl 3):10–16. https://doi.org/10.1157/13101085CrossRefPubMed

30.

Hagem AM, Thorsrud A, Sandvik GF et al (2019) Randomized Study of Collagen Cross-Linking With Conventional Versus Accelerated UVA Irradiation Using Riboflavin With Hydroxypropyl Methylcellulose: Two-Year Results. Cornea 38:203–209. https://doi.org/10.1097/ico.0000000000001791CrossRefPubMed

31.

Hashemi H, Miraftab M, Seyedian MA et al (2015) Long-term Results of an Accelerated Corneal Cross-linking Protocol (18 mW/cm2) for the Treatment of Progressive Keratoconus. Am J Ophthalmol 160:1164-1170.e1161. https://doi.org/10.1016/j.ajo.2015.08.027CrossRefPubMed

32.

Hashemian H, Jabbarvand M, Khodaparast M et al (2014) Evaluation of corneal changes after conventional versus accelerated corneal cross-linking: a randomized controlled trial. J Refract Surg 30:837–842. https://doi.org/10.3928/1081597x-20141117-02CrossRefPubMed

33.

Sadoughi MM, Einollahi B, Baradaran-Rafii A et al (2018) Accelerated versus conventional corneal collagen cross-linking in patients with keratoconus: an intrapatient comparative study. Int Ophthalmol 38:67–74. https://doi.org/10.1007/s10792-016-0423-0CrossRefPubMed

34.

Sherif AM (2014) Accelerated versus conventional corneal collagen cross-linking in the treatment of mild keratoconus: a comparative study. Clin Ophthalmol 8:1435–1440. https://doi.org/10.2147/opth.S59840CrossRefPubMedPubMedCentral

35.

Uçakhan Ö, Yeşiltaş YS (2020) Comparative 2-year outcomes of conventional and accelerated corneal collagen crosslinking in progressive keratoconus. Int J Ophthalmol 13:1223–1230. https://doi.org/10.18240/ijo.2020.08.07CrossRefPubMedPubMedCentral

36.

Medeiros C, Giacomin N, Bueno R et al (2016) Accelerated corneal collagen crosslinking: Technique, efficacy, safety, and applications. J Cataract Refract Surg 42:1826–1835. https://doi.org/10.1016/j.jcrs.2016.11.028CrossRefPubMed

37.

Wang Z, Carter RE (2018) Ranking of the most effective treatments for cardiovascular disease using SUCRA: Is it as sweet as it appears? Eur J Prev Cardiol 25:842–843. https://doi.org/10.1177/2047487318767199CrossRefPubMed

38.

Spoerl E, Mrochen M, Sliney D et al (2007) Safety of UVA-riboflavin cross-linking of the cornea. Cornea 26:385–389. https://doi.org/10.1097/ICO.0b013e3180334f78CrossRefPubMed

Titel: Network meta-analysis comparing efficacy and safety of different protocols of corneal cross-linking for the treatment of progressive keratoconus
verfasst von: Lan Ding
Ling Sun
Xingtao Zhou
Publikationsdatum: 22.03.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 10/2023
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06026-z

Evaluation of scleral thickness in patients with Fuchs endothelial dystrophy

Cornea

Comparative analysis of ultrasonic elastosonography and contrast-enhanced ultrasonography in the diagnosis of benign and malignant intraocular tumors

Oncology

Visual outcomes and corneal densitometry after allogenic and autologous lenticule intrastromal keratoplasty for the correction of moderate-to-high hyperopia

Refractive Surgery

PRESERFLO ™ MicroShunt versus trabeculectomy: 1-year results on efficacy and safety

Open Access
Glaucoma

Congenital ptosis repair in children: comparison of frontalis muscle suspension surgery and levator muscle surgery

Oculoplastics and Orbit

Correction to: Persistence of vascular empty sleeves in choroidal neovascularization after anti-VEGF therapy in both animal models and humans

Correction

Neu im Fachgebiet Augenheilkunde

Kompetente Gesprächsführung

Augenheilkunde
CME-Artikel

Mit schwierigen Gesprächen und der Übermittlung schlechter Nachrichten ist der Augenarzt/die Augenärztin im Krankenhaus und in der Praxis immer wieder konfrontiert. Eine gute Arzt-Patienten-Kommunikation basiert auf Respekt und Empathie und …

Sekundäre chorioidale Neovaskularisation – Wirklich so häufig?

Photodynamische Therapie
Leitthema

Das Auftreten einer sekundären chorioidalen Neovaskularisation ist eine Komplikation im Rahmen einer chronischen Chorioretinopathia centralis serosa. Die Diagnose wird mittels multimodaler Bildgebung gestellt. Die Therapie erfolgt in der Regel mit …

Therapie der Chorioretinopathia centralis serosa im Vergleich – Mikrosekundenpulslaser versus photodynamische Therapie

Photodynamische Therapie
Leitthema

Zum gegenwärtigen Zeitpunkt steht für die Behandlung der Chorioretinopathia centralis serosa (CCS) keine zugelassene Therapie zur Verfügung. Obwohl die CCS eine hohe Selbstresorptionsrate aufweist, können häufige Rezidive oder eine Chronifizierung …

Diagnostik und Klassifikation der Chorioretinopathia centralis serosa – Was brauche ich wirklich?

Angiografie
Leitthema

Die multimodale Bildgebung spielt bei der Diagnostik und Klassifikation der Chorioretinopathia centralis serosa (CCS) eine bedeutende Rolle. In diesem Beitrag sollen die wichtigsten Bildgebungsmodalitäten bei der CCS wie optische …

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Network meta-analysis comparing efficacy and safety of different protocols of corneal cross-linking for the treatment of progressive keratoconus

Abstract

Purpose

Methods

Results

Conclusion

Weitere Artikel der Ausgabe 10/2023

Evaluation of scleral thickness in patients with Fuchs endothelial dystrophy

Comparative analysis of ultrasonic elastosonography and contrast-enhanced ultrasonography in the diagnosis of benign and malignant intraocular tumors

Visual outcomes and corneal densitometry after allogenic and autologous lenticule intrastromal keratoplasty for the correction of moderate-to-high hyperopia

PRESERFLO ™ MicroShunt versus trabeculectomy: 1-year results on efficacy and safety

Congenital ptosis repair in children: comparison of frontalis muscle suspension surgery and levator muscle surgery

Correction to: Persistence of vascular empty sleeves in choroidal neovascularization after anti-VEGF therapy in both animal models and humans

Neu im Fachgebiet Augenheilkunde

Kompetente Gesprächsführung

Sekundäre chorioidale Neovaskularisation – Wirklich so häufig?

Therapie der Chorioretinopathia centralis serosa im Vergleich – Mikrosekundenpulslaser versus photodynamische Therapie

Diagnostik und Klassifikation der Chorioretinopathia centralis serosa – Was brauche ich wirklich?

Update Augenheilkunde

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten