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Iontophoresis corneal collagen cross-linking with enhanced fluence and pulsed uv-a light: three-year clinical results

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First Author: S.Bagaglia ITALY

Co Author(s):    C. Mazzotta   M. Fruschelli                 

Abstract Details

Purpose:

To assess 3-years safety and efficacy of Enhanced-Fluence Pulsed-Light Iontophoresis Cross Linking (EF I-CXL) in patients with progressive Keratoconus (KC).

Setting:

1) Department of Medicine, Surgery and Neurosciences, Opthalmology Operative Unit, Post Graduate Ophthalmology School, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 8, Siena (SI), Italy 2) Siena Crosslinking Center, Via Sandro Pertini 7, Monteriggioni, Siena, Italy

Methods:

Prospective interventional pilot study including 24 eyes of 20 patients, mean age 23.9 years (range 15-36 y). Iontophoresis with Ricrolin+® was used for stromal imbibition. The treatment Energy was optimized at 30% (7J/cm2) and UV-A power set at 18mW/cm2 x 6.28 min of pulsed-light on-off exposure, with a total irradiation time of 12.56 min. Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), Corneal Tomography and Corneal OCT at baseline, 1,3,6,12-24-36 months were evaluated.

Results:

3-years statistically significant data (p <0.05) showed that average UDVA decreased from 0.50 ± 0.10 to 0.36 ± 0.08, average K max decreased from 52.94 ± 1.34 D to 51.4 ±1.49 D (Delta: -1.4±0.8 D), average Coma improved from 0.24 ±0.05µm to 0.12 ±0.02µm (p=0.001) and Symmetry Index (SI) decreased from 4.22±1.01 D to 3.53±0.90 D. Corneal OCT showed a demarcation line detection at 285.8 ±20.2 µm average depth in over 80% at first month follow-up.

Conclusions:

The 3-years results of EF I-CXL improves I-CXL functional outcomes increasing the visibility and the depth of demarcation line closer to epithelium-off S-CXL

Financial Disclosure:

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