Posters

The treatment modification of progressive keratoconus using corneal collagen cross-linking with riboflavin and UVA irradiation

Poster Details

First Author: M. Vesela CZECH REPUBLIC

Co Author(s):    D. Barakova   P. Rozsival                 

Abstract Details

Purpose:

The aim of the study is comparison of different types of epithelium removal in modificated epi-off corneal cross-linking and to evaluate influence of partial and total epithelium removal for halting the progression of keratoconus.

Setting:

Thirty five eyes of 28 patients diagnosed as having progressive keratoconus who underwent CXL were included in this prospective non-randomized clinical study.

Methods:

Thirty five eyes were devided into two groups. Group A was included 15 eyes with the partial epithelium removal in the lower part of the cornea. Group B was comprised 20 eyes with the circular shape of corneal epithelium removal of size 8-9 mm. The corneal cross-linking was performed using the Dresden protocol in both groups. Outcome parameters including corneal epithelium healing, the pain intensity, uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BDVA), Scheimpflug corneal tomography parameters and endothelial cell count (ECC) were assessed before and a year after the procedure.

Results:

In group A, better corneal epithelium healing, less pain intensity, better pachymetry and endothelial cell count were found. All topographic parameters (including maximum keratometry) were stable during the follow-up, but exhibited a positive non-significant trend toward improvement. In group B, better visual functions a manifest refraction were found due to remodeling of corneal tissue and improvement of HOA. Push-up effect was observed in both goups.

Conclusions:

Preliminary results up to 1 year post-operatively indicate the efficacy of epi-off CXL in stabilizing the progression of this degenerative disease combined with improvement of tomography and visual functions. CXL with partial epithelium removal, which spares the corneal epithelium, has the potential to become a valid alternative for halting the progression of keratoconus while reducing postoperative patient pain, risk of infection, and treatment time in select patients; however, the relative efficacy of this technique compared to standard epithelium-off techniques remains to be determined.

Financial Disclosure:

NONE