Posters

A comparaitive study of continuous vs pulsed mode in accelerated corneal collagen cross-linking (KXL) for keratoconus

Poster Details

First Author: N. Ds INDIA

Co Author(s):    V. Bhandari   K. Relekar   S. Ganesh   S. Brar           

Abstract Details

Purpose:

To assess the efficacy and to compare the outcomes of continuous(C-KXL) and pulsed mode(P-KXL) in accelerated corneal collagen cross linking (KXL) for keratoconus

Setting:

Single centre, prospective, comparative, randomized, interventional case series

Methods:

100 eyes of 50 patients with mean age of 24±3.6 years with bilateral progressive keratoconus underwent P-KXL in right eye and C-KXL in left eye. Mean follow up was at 6 months and at each follow-up examination UDVA(uncorrected distant visual acuity), CDVA(corrected distant visual acuity), post-treatment manifest spherical equivalent (MSE) and astigmatism, corneal topography to assess average Keratometry value (Km) and maximal curvature reading at the corneal apex (Kmax), Corvis ST to measure corneal deformation amplitude index (DAI), AS-OCT, Corneal topography and specular microscopy were done and compared to the preoperative data, and adverse events, if any, were recorded

Results:

At the end of followup, P-KXL and C-KXL groups showed significant improvement in both UDVA and CDVA post-treatment though the difference between the two was not statistically significant. CDVA improved from 0.21±0.1 logMAR to 0.16±0.1 logMAR (p=0.081) and from 0.18±0.12 logMAR to 0.12±0.17 logMAR(p=0.07) in P-KXL and C-KXL groups respectively. In both groups, Km Kmax , DAI showed significant decrease, with no statistically significant difference between them. Demarcation line was seen at a depth of 251.13±18.28µ and 245.28.±28.26µ respectively in P-KXL and C-KXL groups at mean follow up . Post treatment, both groups showed no statistically significant endothelial cell loss and coma aberrations were stable.

Conclusions:

C-KXL can give similar functional outcomes as P-KXL with the help of supplemental oxygen delivery with the added advantage of a shortened procedure time and reduced energy dose delivered without compromising on the outcome. This may be particularly useful when refractive procedures like PRK and LASIK are combined with KXL when an overall shortened procedure time is more acceptable and patient friendly. Considering the ease and minimal extra effort and cost of supplemental oxygen delivery techniques, C-KXL seems a viable option. However, we need further long term studies to validate our outcome.

Financial Disclosure:

NONE