Posters

Repeated conventional cross-linking due to insufficient epi-on protocol with progressive keratoconus

Poster Details

First Author: E.Usubov RUSSIA

Co Author(s):    M. Bikbov   E. Usubov   G. Kazakbaeva   I. Rusakova           

Abstract Details

Purpose:

to study the efficacy and safety of re-UV epi-off corneal crosslinking in patients with progressive keratoconus after insufficient transepithelial crosslinking

Setting:

crosslinking in progressive keratoconus

Methods:

A retrospective analysis of the results of the treatment of 27 patients (27 eyes) with progressive keratoconus stage I-II according to the Amsler-Krumeich classification, which from 2012 to 2014 underwent the epi-on corneal crosslinking. Based on objective clinical studies, the efficacy of the treatment and the course of the process in 12 patients (12 eyes) with a progression (increase of refractive power –Kave, reduce of corneal thickness – CT, dynamics of corneal astigmatism – CA), after the TE-CXL underwent a procedure of repeated of the corneal crosslinking according to the standard protocol (S-CXL)

Results:

12 eyes (44%) after TE-CXL within 24-48 months showed progression, manifested by increase of  Kave by 0.95±0.18D, a decrease of CT from 484±156 to 446±87 mc. Repeated S-CXL was performed, after 6 months positive dynamics was observed in 10 cases (83.3%), VA reached the pre-operative level, Kave was 50.3±0.84 diopters. Stabilization was in all 12 eyes, a decrease in Kave - 1.1±0.2D, CA - 1.2±0.5D, the CT to 427±38.7 mc. 1 year postop, the increase in UCVA to 0.22±0.1 and BCVA to 0.6±0.12 was established. The Kave decreased to 49.3±0.44 D, in 1 case it did not change significantly

Conclusions:

The use of modified crosslinking protocols, in particular transepithelial with iontophoresis, has a lower efficiency, showing stabilization in (56% of cases), compared to the standard, which must be considered when choosing a clinical approach and selecting patients. Repeated crosslinking with the standard protocol in patients with a progressive course after TE-CXL showed the efficiency and safety of the procedure in 100% of cases, however, this approach should be studied on a greater number of observations

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