Pilot evaluation of photorefractive corneal collagen cross-linking for the treatment of low myopia: 6 month results

Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 14:24

Venue: Room 4.6

First Author: : S.El Hout FRANCE

Co Author(s): :    M. Sales de gauzy   M. cassagne   M. Fournie   M. Malecaze           

Abstract Details

Purpose:

Over the past several years, corneal collagen crosslinking (CXL) has become popular for treatment of ectatic disease since it enhances biomechanical rigidity of the intrastromal collagen matrix leading to flattening of the cornea and refractive stabilization. We conducted a prospective study to evaluate the safety and efficacy of a new photorefractive application of epi-on CXL to treat myopic error on non-keratoconic eyes with low myopia.

Setting:

Prospective study at Purpan hospital. The inclusion criteria was age more than 18 years old and having myopia with manifest refraction spherical equivalent of -1.00 to -2.50 D, with cylindral component plan to -0.75 D. Only the non-dominant eye was treated. Patients were evaluated at 1, 3 and 6 months.

Methods:

The surgical protocol involves applying an oxygen mask on the eye for optimal supplemental oxygen delivery, then soaking with riboflavin during 10 minutes and finally initiating UVA 365 nm wavelength light, 30 mW/ cm2 pulsed irradiation, centered on pupil. Outcomes measured were uncorrected and best corrected visual acuity (UCVA and BCVA), mean change in manifest refraction spherical equivalent (MRSE) from baseline, mean change in mean keratometry from baseline on refractometer (Nidek), specular topography (TMS4, Tomey) and elevation topography (Pentacam, Oculus) , and endothelial cell count (ECC). Adverse events was also evaluated. 6 month results will be presented.

Results:

16 eyes were treated with epi-on photorefractive CXL from september 2016 through march 2017. At 3 months, UCVA increased by 2.7 ± 2.2 lines (P <0.01). MRSE was reduced by 0,70 ± 0.39D (P <0.001). Mean keratometry decreased on specular topography by 0.4 ± 0.16D (P <0.001), elevation topography by 0.87 ± 0.55 D (P < 0.1), Keratometer by 0.35 ± 0.27 D (P <0.01). Moderate haze was observed in all patients, maximal at 1 month. There were no other side effects, ECC and BCVA were unchanged.

Conclusions:

Transepithelial photorefractive CXL reduces refractive error in patients with low myopia. It is a non invasive method without tissue ablation suitable for patients with thin corneas.

Financial Disclosure:

NONE