Performing corneal crosslinking under local anaesthesia in patients with Down syndrome

Nienke Soeters; Esmée Bennen; Robert P.L. Wisse

doi:10.1007/s10792-017-0535-1

Performing corneal crosslinking under local anaesthesia in patients with Down syndrome

Nienke Soeters^*
, Esmée Bennen
, Robert P.L. Wisse

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

PURPOSE: To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome.

METHODS: Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia.

RESULTS: In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (<400 µm) prior to ultraviolet-A irradiation, even after employing hypoosmolar riboflavin. No adverse events occurred post-operatively, except for one case of delayed epithelial healing (23 days).

CONCLUSIONS: With a proper patient selection, CXL under local anaesthesia can be achieved in patients with Down syndrome.

Original language	English
Pages (from-to)	917-922
Number of pages	6
Journal	International Ophthalmology
Volume	38
Issue number	3
DOIs	https://doi.org/10.1007/s10792-017-0535-1
Publication status	Published - Jun 2018

Keywords

Corneal crosslinking
CXL
Down syndrome
Keratoconus
Local anaesthesia
Photosensitizing Agents/therapeutic use
Prospective Studies
Follow-Up Studies
Keratoconus/complications
Humans
Photochemotherapy/methods
Visual Acuity
Corneal Stroma
Young Adult
Ultraviolet Rays
Collagen/therapeutic use
Adolescent
Adult
Anesthesia, Local/methods
Down Syndrome/complications
Cross-Linking Reagents/therapeutic use
Riboflavin/therapeutic use

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10.1007/s10792-017-0535-1

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@article{aa72bbcc0e5949d0af113ce22ccca3a9,

title = "Performing corneal crosslinking under local anaesthesia in patients with Down syndrome",

abstract = "PURPOSE: To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome.METHODS: Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia.RESULTS: In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (<400 µm) prior to ultraviolet-A irradiation, even after employing hypoosmolar riboflavin. No adverse events occurred post-operatively, except for one case of delayed epithelial healing (23 days).CONCLUSIONS: With a proper patient selection, CXL under local anaesthesia can be achieved in patients with Down syndrome.",

keywords = "Corneal crosslinking, CXL, Down syndrome, Keratoconus, Local anaesthesia, Photosensitizing Agents/therapeutic use, Prospective Studies, Follow-Up Studies, Keratoconus/complications, Humans, Photochemotherapy/methods, Visual Acuity, Corneal Stroma, Young Adult, Ultraviolet Rays, Collagen/therapeutic use, Adolescent, Adult, Anesthesia, Local/methods, Down Syndrome/complications, Cross-Linking Reagents/therapeutic use, Riboflavin/therapeutic use",

author = "Nienke Soeters and Esm{\'e}e Bennen and Wisse, \{Robert P.L.\}",

note = "Funding Information: Acknowledgements Robert PL Wisse was supported for research by the Dr. F.P. Fischer Stichting, the Netherlands, by an unrestricted grant. There is no financial interest for any of the authors, their families, or direct business associates. The manuscript was presented in public as a poster at the 11th International Congress of Corneal Cross-linking 2015, 05 December, 2015, Boston, USA, presented as a paper at the Nederlands Contactlens Congres, 14 March, 2016, Veldhoven, the Netherlands, and presented as a paper at the Nederlands Oogheelkundig Gezelschap, 06 April, 2016, Maastricht, the Netherlands. Publisher Copyright: {\textcopyright} 2017, The Author(s). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",

year = "2018",

month = jun,

doi = "10.1007/s10792-017-0535-1",

language = "English",

volume = "38",

pages = "917--922",

journal = "International Ophthalmology",

issn = "0165-5701",

publisher = "Springer Science and Business Media B.V.",

number = "3",

}

TY - JOUR

T1 - Performing corneal crosslinking under local anaesthesia in patients with Down syndrome

AU - Soeters, Nienke

AU - Bennen, Esmée

AU - Wisse, Robert P.L.

N1 - Funding Information: Acknowledgements Robert PL Wisse was supported for research by the Dr. F.P. Fischer Stichting, the Netherlands, by an unrestricted grant. There is no financial interest for any of the authors, their families, or direct business associates. The manuscript was presented in public as a poster at the 11th International Congress of Corneal Cross-linking 2015, 05 December, 2015, Boston, USA, presented as a paper at the Nederlands Contactlens Congres, 14 March, 2016, Veldhoven, the Netherlands, and presented as a paper at the Nederlands Oogheelkundig Gezelschap, 06 April, 2016, Maastricht, the Netherlands. Publisher Copyright: © 2017, The Author(s). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.

PY - 2018/6

Y1 - 2018/6

N2 - PURPOSE: To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome.METHODS: Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia.RESULTS: In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (<400 µm) prior to ultraviolet-A irradiation, even after employing hypoosmolar riboflavin. No adverse events occurred post-operatively, except for one case of delayed epithelial healing (23 days).CONCLUSIONS: With a proper patient selection, CXL under local anaesthesia can be achieved in patients with Down syndrome.

AB - PURPOSE: To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome.METHODS: Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia.RESULTS: In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (<400 µm) prior to ultraviolet-A irradiation, even after employing hypoosmolar riboflavin. No adverse events occurred post-operatively, except for one case of delayed epithelial healing (23 days).CONCLUSIONS: With a proper patient selection, CXL under local anaesthesia can be achieved in patients with Down syndrome.

KW - Corneal crosslinking

KW - CXL

KW - Down syndrome

KW - Keratoconus

KW - Local anaesthesia

KW - Photosensitizing Agents/therapeutic use

KW - Prospective Studies

KW - Follow-Up Studies

KW - Keratoconus/complications

KW - Humans

KW - Photochemotherapy/methods

KW - Visual Acuity

KW - Corneal Stroma

KW - Young Adult

KW - Ultraviolet Rays

KW - Collagen/therapeutic use

KW - Adolescent

KW - Adult

KW - Anesthesia, Local/methods

KW - Down Syndrome/complications

KW - Cross-Linking Reagents/therapeutic use

KW - Riboflavin/therapeutic use

UR - https://www.scopus.com/pages/publications/85018509910

U2 - 10.1007/s10792-017-0535-1

DO - 10.1007/s10792-017-0535-1

M3 - Article

C2 - 28424993

AN - SCOPUS:85018509910

SN - 0165-5701

VL - 38

SP - 917

EP - 922

JO - International Ophthalmology

JF - International Ophthalmology

IS - 3

ER -

Performing corneal crosslinking under local anaesthesia in patients with Down syndrome

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