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Transepithelial corneal collagen cross-linking in thin corneas

Session Details

Session Title: Cross-linking

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 14:42

Venue: Elicium 2 (First Floor)

First Author: : L.Spadea ITALY

Co Author(s): :                  

Abstract Details

Purpose:

To report the results of transepithelial corneal collagen cross-linking (CXL) with modified riboflavin and UVA irradiation in patients affected by keratoconus and post-LASIK ectasia with a thinnest pachymetry value less than 400?m, not treatable by the standard technique with de-epithelialization.

Setting:

L"Aquila University

Methods:

Twenty patients affected by progressive keratoconus or post-LASIK ectasia with thinnest pachymetry values ranging from 331 ?m to 389 ?m underwent transepithelial CXL in one eye using a riboflavin 0.1% solution in 15% Dextran T500 containing ethylenediamine tetra-acetic acid 0.01% and trometamol to enhance epithelial penetration. The patients underwent complete ophthalmological examination, including endothelial cell density measurements and computerized videokeratog¬raphy, before CXL and at one day, one week, and one, 6, and 12 months thereafter.

Results:

Epithelial healing was complete in all patients after one day of use of a soft bandage contact lens. No side effects or damage to the limbal region was observed during the follow-up period. All patients showed slightly improved uncorrected and spectacle-corrected visual acuity; keratometric astigmatism showed reductions (up to 5.3 D) and apical ectasia power decreased (Kmax values reduced up to 4.3 D). Endothelial cell density was unchanged.

Conclusions:

Application of transepithelial CXL using riboflavin with substances added to enhance epithelial permeability was safe, seemed to be moderately effective in eyes with ultrathin corneas, and applications of the procedure could be extended to patients with advanced ectasias.

Financial Interest:

NONE