Session Title: Cornea
Session Date/Time: Sunday 05/02/2012 | 08:30-11:00
Paper Time: 09:00
Venue: Hall 1
First Author: : L.Spadea ITALY
Co Author(s): : R. Mencucci
Purpose:
To report the results of transepithelial corneal collagen cross-linking (CXL) with modified riboflavin and UVA irradiation in eight patients affected by keratoconus with a thinnest pachymetry value less than 400μm, not treatable by the standard technique with de-epithelialization.
Setting:
University of L'Aquila, Eye Clinic, L’Aquila - Italy
Methods:
Eight patients affected by progressive keratoconus with a thinnest pachymetry value from 356 to 386μm underwent transepithelial CXL in one eye using a riboflavin 0.1% solution in 15% dextran T500 containing EDTA 0.01%, and tromethamol to enhance the epithelial penetration (Ricrolin TE®, Sooft, Montegiorgio, Italy). Before treatment and 1 day, 1 week, 1 month and 6 months after the treatment patients underwent complete ophthalmological examination, including endothelial cell density measurements and computerized videokeratography. Six months after transepithelial CXL one patient underwent a triple procedure (penetrating keratoplasty, open sky extracapsular cataract extraction and intraocular lens implantation). The explanted cornea was sent for immunohistochemical analysis. The expression of Connexin-43 and CD34 proteins were evaluated. RESULTS Epithelial healing was complete after one day of use of soft contact lens bandage. No side effects or damage to the limbal region were observed during the follow-up period. Best spectacle- corrected visual acuity improved, keratometric astigmatism showed a reduction (from 0.1 to 2.2D)and the power of ectasia apex decreased (K max values reduced from 1 to 3D). Mean endothelial cell density was unchanged. Six months after treatment immunohistochemical analysis of one cornea showed structural and functional integrity of epithelium, endothelium and stroma.
Conclusions:
The application of transepithelial CXL by using a riboflavin added with substances enhancing epithelial permeability was safe and seems to be effective in keratoconic eyes with ultrathin corneas, and could expand the applications of the procedure in patients with advanced keratoconus stages.
Financial Disclosure:
No
