Posters
Optical coherence tomography and confocal microscopy evaluation after standard and transepithelial corneal collagen cross-linking by iontophoresis for progressive keratoconus in paediatric patients
Poster Details
First Author: L. Lapenna ITALY
Co Author(s): E. Alba MD A. Acquaviva MD
Abstract Details
Purpose:
To compare the efficacy and early morphological changes in the cornea following Standard epi-off cross-linking and Iontophoresis transepithelial cross-linking (I-CXL) in progressive keratoconus
Setting:
Iontophoresis transepithelial cross-linking (I-CXL)
Standard epi-off cross-linking
Methods:
twenty-four eyes, of 18 pediatric patients affected by progressive keratoconus (grade 1-3) were enrolled in this prospective study.The mean age was 16.7 ± 2.4years ranging between 14 to 18 years. In all of the patients was detected an increase of maximal keratometry(Kmax), of at least 1.00 diopter(D) over a 12 months period. Minimum pachimetry was higher than 400 µm. These cases were divided into two groups: Standard CXL (12 eyes) and I-CXL (12 eyes). UCVA, BSCVA, refraction, maximal keratometry(Kmax), confoscan microscopy and anterior segmet optical coherence tomography (as-OCT) were evaluated at baseline and at 1,3,6 and 12 months.
Results:
Compared to preoperative values, mean corneal sub-basal nerve and anterior stromal keratocyte densities were significantly lower at 6 months in the Standard CXL group (P< 0.001), whereas they returned to preoperative values in the I-CXL group. Corneal demarcation line was measured in 94% of the eyes treated with the Standard CXL, at a mean depth of 335.8 ±69.6 µm (P<0.005). For the I-CXL, the corneal demarcation line was seen only in 43.6% eyes at a mean depth of 240 ± 35.6µm (P=0.005).
Conclusions:
: I-CXL was associated with weaker damage of corneal sub-basal nerves and anterior keratocytes compared to the standard procedures, but the demarcation line was present in less than 50% of cases and was more superficial than the standard procedure.
Financial Disclosure:
NONE
