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Evaluation of transepithelial corneal collagen cross-linking (CXL) at 6 months and 1 year follow-up in patients with different proprietary transepithelial riboflavin solutions

Session Details

Session Title: Cross-linking

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

Paper Time: 14:48

Venue: Elicium 2 (First Floor)

First Author: : R.Rubinfeld USA

Co Author(s): :    M. Mrochen   G. Perez   T. Person   C. Kaiser   W. Trattler   R.

Abstract Details

Purpose:

Transepithelium corneal cross linking has been reported to be ineffective. The Purpose of this analysis was to demonstrate efficacy and compare operative procedure time relative to standard crosslinking in a clinical setting.

Setting:

Washington Eye Physicians and Surgeons, Chevy Chase, MD, IROC Science to Innovation AG, Zurich, Switzerland, Center for Excellence in Eye Care, Miami, Fl

Methods:

Patients with a diagnosis of keratoconus or post-Lasik ectasia who had undergone Transepithelial CXL in one or both eyes were included in this analysis. Patients with previous RK, INTACS, repeat CXL procedures, and/or patients who were pseudo-phakic or had a diagnosis of cataract were excluded from this analysis. Outcome measures included intraoperative transepithelial corneal stromal riboflavin loading times, and UCVA, BSCVA, and K Max at 6 months and 1 year follow up visits. Corneal stromal loading was assessed by slit lamp examination.

Results:

199 eyes were treated with proprietary riboflavin formulation 1. Loading time ranged from 30 to 100 minutes (average 56.3 minutes). 70% of these eyes were male and the average age was 35.7 years old. 84% of eyes had a pre-Op diagnosis of keratoconus. 127 eyes were treated with proprietary riboflavin formulation 2. Loading time ranged from 8 to 60 minutes (average 22.17 minutes). 70% of these eyes were male and the average age was 36 years old. 88% of eyes had a pre-Op diagnosis of keratoconus. At 6 months post-CXL, 52% and 52% of eyes (formulation 1) and 45% and 47% of eyes (formulation 2) improved 1 or more lines in UCVA and BSCVA from pre-Op. Patients treated with formulation 1 and formulation 2 experienced 0.24D flattening and 1.36D in K Max, respectively, at 6 months follow-up. At 1 year follow up, 59% and 55% of eyes (formulation 1) and 63% and 50% of eyes (formulation 2) experienced 1 or more lines of improvement in UCVA and BSCVA. Patients treated with formulation 1 and formulation 2 experienced 0.52D flattening and 2.00D flattening, respectively, in K max from Pre-Op.

Conclusions:

The efficacy of trans-epithelium corneal cross linking depends on the formulation and the application of the solution. The presented results demonstrate that trans- epithelium cross linking with an appropriate formulation can provide an efficacy that is comparable to the epi-off Dresden protocol without substantial increase in the loading time.

Financial Interest:

... gains financially from product or procedure presented