Patterned cross-linking (PiXL) for refractive errors with epithelium-on (EPI ON) or epithelium-off (EPI OFF) or corneal pocket approach

Session Details

Session Title: Keratoconus & Secondary Ectasia

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 09:45

Venue: Free Paper Forum: Podium 2

First Author: : C.Kranemann CANADA

Co Author(s): :                                 

Abstract Details

Purpose:

To determine the efficacy and safety of PiXL with an EPI ON or EPI OFF or Pocket approaches

Setting:

Refractive clinic

Methods:

Prospective cohort of patients underwent a refractive treatment for up to 2 diopters of sphere and/or 1.5 diopters of cylinder using PiXL. Patients were randomized to EPI ON or EPI OFF or a corneal pocket approach. Accelerated CXL with energies of 13-15 Joules was applied with Oxygen supplementation. All patients had pre- and postoperative topography/wavefront/cycloplegic refractions/endothelial cell count/tear osmolality and recording of any complications

Results:

A total of 30 eyes in 16 patients were treated. 11 eyes were in the EPI ON, 9 in the EPI OFF and 10 in the Pocket groups. All patients in the EPI ON group improved within 1 day whereas both the EPI OFF and Pocket groups required at least 10 days to show any improvement. Within 6 months the EPI ON group returned to baseline with refraction and keratometry as did the EPI OFF group within 12 months. At month 12 only the Pocket group showed a consistent treatment effect with an average correction of 0.98 diopters with a corresponding change in Keratometry readings. There were no adverse effects in any of the groups.

Conclusions:

The efficacy of the EPI ON or EPI OFF treatment approaches could not be proven with the current treatment protocol, though the Pocket approach showed potential promise. Further refinements of the treatment protocol are likely required before this approach can be fully validated.

Financial Disclosure:

None