Posters

Contact lens-assisted corneal collagen cross-linking (CXL) with isotonic riboflavin in thin corneas (<400 microns): an evaluation of visual outcome and progression of corneal ectasia

Poster Details

First Author: M. Rajamani INDIA

Co Author(s):    S. Jacob   A. Agarwal                 

Abstract Details

Purpose:

To evaluate the progression of keratectasia of >1D and refraction in patients with progressive corneal ectasia with a corneal thickness of <400microns undergoing contact lens assisted CXL(CACXL)

Setting:

This study was done on patients of progressive corneal ectasia with thin corneas operated for CACXL at Dr. Agarwal’s Eye Hospital and Eye Research Centre, Chennai.Pre operative evaluation is done following all standard norms.Post operative parameters were evaluated on Day 1,7 and at 1,3, 6 and 12 months postoperatively.

Methods:

All patients underwent CACXL procedure (epi-off) under topical anesthesia.Iso-osmolar riboflavin 0.1% was applied every 3 minutes for 30 minutes.A Contact lens,soaked in Iso-osmolar riboflavin for 30 minutes, is then applied on the abraded cornea and exposed to crosslinking by UV-A light (370nm) at an irradiance of 3mW/cm2 for 30 minutes.During which time,riboflavin 0.1% is applied both over and under to contact lens to maintain riboflavin saturation in the cornea and also to maintain the pre-contact lens and pre-corneal riboflavin films.After treatment,the riboflavin soaked contact lens is removed,thorough BSS wash is given and a bandage contact lens left in situ.

Results:

Statistically significant improvement was noted in the Uncorrected Visual Acuity and Best Corrected Visual Acuity. No statistically significant change noted between pre and post-operative spherical refraction. Manifest Refraction Cylinder improved significantly from -3.5+1.69D pre-operatively to -2.74+1.81D post operatively. Maximum keratometry, minimum keratometry and SimK showed no significant change between the pre and post-operative values. There was no statistically significant change between the pre-operative and post-operative specular counts.

Conclusions:

There is a significant improvement in both the uncorrected and best corrected visual acuity over time. Stabilization of the keratometric indices implies the halt in the progression of the ectasia.The stable endothelial count indicates that good UV-A attenuation is attained at the endothelial level.Hence,CACXL is a safe and effective procedure in halting the progression of keratectasia in patients with thin corneas.

Financial Disclosure:

NONE