Corneal biomechanical and cell changes of four transepithelial corneal collagen cross-linking techniques in progressive keratoconus

Session Details

Session Title: Cross-Linking

Session Date/Time: Sunday 06/09/2015 | 08:00-09:30

Paper Time: 08:57

Venue: Main Auditorium

First Author: : Q.Zeng CHINA

Co Author(s): :    M. Hu                    

Abstract Details

Purpose:

To evaluate early corneal biomechanical changes of four transepithelial corneal collagen crosslinking (TE-CXL) techniques in progressive keratoconus.

Setting:

Zeng Qingyan, Hu Ming. Aier School of Ophthalmology, Central South University, Changsha, China, and Hankou Aier Eye Hospital, Wuhan, China.

Methods:

Forty eyes of 40 keratoconus patients randomly divided into four groups were treated with different TE-CXL techniques: (A) application of hypo-osmolar riboflavin (Ricrolin TE) for 30 minutes; (B) riboflavin (Ricrolin+) application by iontophoresis for 5 minutes; (C) riboflavin (Ricrolin+) application by iontophoresis for 10 minutes. In these three groups UV-A treatment was performed at 10 mW/cm2 for 9 minutes. (D) application of riboflavin (ParaCel and VibeX Xtra) followed with pulsed light accelerated CXL (pl-ACXL) at 45 mW/cm2 for 2 minutes. Pre- and postoperative corneal densitometry, demarcation line, and corneal stroma were assessed using Pentecam HR, anterior-segment OCT and confocal microscopy.

Results:

The follow-up time was 6 months. The anterior 120 um layer corneal densitometry in the central 6 mm district increased postoperatively, reached summit at 7 days and then fell. The most significant increase were found in the 10 minutes iontophoresis group. Demarcation lines were detected in 90% 10 minutes iontophoresis group, 70% 5 minutes iontophoresis group, 40% pl-ACXL group and 40% hypo-osmolar riboflavin group; and the depth of demarcation line were 237 ± 45 um, 214 ± 45 um, 206 ± 47 um,144 ± 38 um, respectively (P= 0.01). Confocal microscopy revealed the apoptosis and activation of corneal stromal cells between 1 and 6 months, which was remarkable in 10 minutes iontophoresis group.

Conclusions:

In these four TE-CXL techniques, 10 minutes iontophoresis seemed to induce most significant corneal biomechanical and cell changes, which was detected in standard epi-off CXL.

Financial Interest:

NONE