Functional and anatomical outcomes of TE iontophoresis corneal collagen cross-linking in young adult progressive keratoconus

Session Details

Session Title: Presented Poster Session: Cross-Linking

Session Date/Time: Sunday 06/09/2015 | 15:00-16:30

Paper Time: 15:00

Venue: Poster Village: Pod 4

First Author: : S.Troisi ITALY

Co Author(s): :    E. Chiariello Vecchio   A. Greco   R. Carelli   V. Turco   A. Magli  

Abstract Details

Purpose:

To evaluate functional and anatomical outcomes of transepithelial iontophoresis corneal collagen cross-linking (I-CXL) in young adult patients with progressive keratoconus. The transepithelial iontophoresis Corneal Cross-Linking (I-CXL) is an innovative treatment that can potentially block or slow the disease progression. I-CXL reduces the treatment duration if compare with standard procedure. Corneal absorption phase with riboflavin (RICROLIN®+; SOOFT,Montegiorgio,Italy) and UV-A irradiation at 10 mW/cm2 for 9 minutes.

Setting:

Department of Ophthalmology - Hospital University of Salerno (Italy), Department of Pediatric Ophthalmology - University of Salerno (Italy)

Methods:

Totally 28 patients (37 eyes), with a diagnosis of progressive keratoconus, who underwent I-CXL at the Salerno Hospital University from March 2013 to March 2014 . Inclusion criteria were diagnosis of progressive keratoconus, central corneal thickness greater than 400 microns, increased apical curvature of the cone at least of 1 D in the previous six months, clear cornea to biomicroscopy. Exclusion criteria were presence of corneal opacity central or eccentric, severe dry eye, corneal infections, autoimmune diseases, diseases of the lens or retina.

Results:

37 eyes of 28 patients (17M,11F) were evaluated. Mean age was 30±2.3 years(range 18-38). Comparative analyses at baseline,1,3,6 and 12 months of follow-up was performed. We performed uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA), slit-lamp biomicroscopy, IOP, corneal topography and pachymetry with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany), in vivo confocal microscopy (HRTII, Rostock Cornea Module,Heidelberg,Engineering,Germany). After treatment all topometric values evaluated with Pentacam showed stability during follow-up entirely; there was an improvement in mean BCVA preoperative, mean endothelial cell count did not significantly change during follow-up (p<0.05),intraocular pressure did not show any significant change. No significant haze.No infection.

Conclusions:

Trans-epithelial technique offers very promising visual and topographic outcomes with superior patient comfort postintervention. Relatively small number of treated patients and the follow-up limited to 1 year are limitations of this study. In our opinion I-CXL is valid alternative to slow or stop the progression of keratoconus reducing postoperative patient pain, risk of infection, and treatment time.

Financial Interest:

NONE