Iontophoretic transepithelial collagen cross-linking vs epithelium-off collagen cross-linking in paediatric patients

Session Details

Session Title: Corneal Cross-Linking

Session Date/Time: Monday 16/09/2019 | 16:00-18:00

Paper Time: 16:06

Venue: South 5

First Author: : L.Buzzonetti ITALY

Co Author(s): :    G. Petrocelli                             

Abstract Details

Purpose:

To compare 3 year iontophoretic transepithelial corneal cross-linking (I-ON CXL) outcomes with epithelium-off collagen cross-linking (epi-off CXL) in pediatric patients.

Setting:

Ophthalmology Department, Bambino Gesù IRCCS Children’s Hospital, Rome, Italy

Methods:

Forty eyes of 28 consecutive pediatric patients (mean age 14.3±2.5 [SD] years) with keratoconus were evaluated. Twenty eyes of 15 patients underwent I-ON and 20 eyes of 13 patients epi-off CXL. Mean corrected distance visual acuity (CDVA), spherical equivalent, maximum keratometry (Kmax), posterior elevation of the thinnest point and thickness of the thinnest point were evaluated. The Student t test was used to compare baseline and postoperative data. Keratoconus progression as a function of preoperative Kmax and cone location was evaluated.

Results:

At 36 months CDVA statistically improved (from 0.18±0.1 to 0.10±0.1 log MAR) in epi-off CXL. Mean Kmax increased from the baseline +0.8 diopters (D) in epi-off and +2.9D in I-ON. In both groups the thinnest point decreased. Keratoconus progression, defined by an increase of Kmax reading of the anterior corneal surface of at least 1.00D, occurred in 25% of epi-off and 50% of I-ON CXL. Kmax value in I-ON, and cone location in both groups, seemed to be factors influencing the disease progression.

Conclusions:

In pediatric patients 3 years after treatment epi-off CXL halted keratoconus progression in 75% of eyes, while I-ON CXL seemed to slow down keratoconus progression in 50% of eyes, mainly in those with highest Kmax and paracentral cone.

Financial Disclosure:

gains financially from competing product or procedure, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives non monetary benefits from a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, is employed by a competing company, has significant investment interest in a company producing, developing or supplying product or procedure presented