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Current clinical pr...
Current clinical practice in corneal crosslinking for treatment of progressive keratoconus in four Nordic countries
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- Gustafsson, Ingemar (author)
- Lund University,Lunds universitet,Klinisk forskning inom hornhinnesjukdomar,Forskargrupper vid Lunds universitet,Clinical research in corneal disease and disorders,Lund University Research Groups,Skåne University Hospital
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- Vicente, André (author)
- Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Bergström, Anders (author)
- Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Stenevi, Ulf (author)
- Sahlgrenska University Hospital
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- Ivarsen, Anders (author)
- Aarhus University Hospital
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- Hjortdal, Jesper Østergaard (author)
- Aarhus University Hospital
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(creator_code:org_t)
- 2022-07-10
- 2023
- English.
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In: Acta Ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 101:1, s. 109-116
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Abstract
Subject headings
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- PURPOSE: To evaluate clinical practice in the diagnosis and treatment of progressive keratoconus with corneal crosslinking (CXL) in four Nordic countries.METHODS: A questionnaire was sent to all centres at which keratoconus patients are evaluated and CXL is performed in Sweden, Denmark, Norway and Iceland. Nineteen of 20 centres participated.RESULTS: CXL is performed approximately 1300 times per year in these four Nordic countries with a population of around 21.7 million (2019). In most cases, progression is evaluated using the Pentacam HR, and the maximum keratometry reading (Kmax ) is considered the most important parameter. The most frequently used treatment protocol in Scandinavia is the 9 mW/cm2 epi-off protocol, using hydroxylpropyl methylcellulose riboflavin (HPMC-riboflavin). The participants deemed the following areas to be in most need of improvement: adaptation of the CXL protocol to individual patients (5/19), the development of effective epi-on treatment protocols (4/19), optimal performance of CXL in thin corneas (4/19), improvement of the definition of progression (2/19), and diagnosis of the need for re-treatment (2/19).CONCLUSIONS: We concluded that the diagnosis of progressive keratoconus and the diagnostic equipment used are similar. Treatment strategies are also similar but are suitably different to provide an interesting basis for the comparison of treatment outcomes. The high degree of participation in this survey indicates the possibility of future scientific collaboration on CXL focusing on the areas deemed to need improvement. It would also be of interest to evaluate the possibility of creating a Nordic CXL Registry. The high number of CXL treatments performed ensures sufficient statistical power to solve many questions. Such a registry could be an important contribution to evidence-based care and would allow for longitudinal evaluation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oftalmologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Ophthalmology (hsv//eng)
Keyword
- Humans
- Keratoconus/diagnosis
- Photochemotherapy/methods
- Photosensitizing Agents/therapeutic use
- Visual Acuity
- Cross-Linking Reagents/therapeutic use
- Riboflavin/therapeutic use
- Scandinavian and Nordic Countries/epidemiology
- Corneal Topography
- Ultraviolet Rays
Publication and Content Type
- art (subject category)
- ref (subject category)
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