First Author: S.Taneri GERMANY
Co Author(s): S. Oehler J. Koch
Purpose:
To evaluate the influence of collagen crosslinking (CXL) with UVA light and riboflavin in keratoconic eyes on the integrity of the ocular surface.
Setting:
: Zentrum für Refraktive Chirurgie, Augenabteilung am St. Franziskus Hospital, Münster, Germany
Methods:
We conducted a prospective single center study, including 30 consecutive eyes of 16 patients. Preoperatively, and 3 and 6 months after crosslinking, intra-individual comparison of the following parameters:
1) fluorescein staining (normal or pathologic; pathologic: more than 10 point-shaped of diffuse staining areas),
2) rose Bengal staining using the van Bijsterfeld-Index. The van Bijsterfeld-index is calculated as the sum of the average intensity of staining of the ocular surface within the palpebral fissure (temporal and nasal conjunctiva, and cornea; 0 - 3 points each, adding to maximum 9 points)
3) height of tear-film meniscus at the lower lid margin (increased, normal, reduced)
4) tear-film break-up-time (<5s, 5-10s, >10s)
5) postoperative versus preoperative signs of dry eye at slit-lamp exam (qualitative score: better, unchanged, worse)
6) subjective symptoms (qualitative score: better, unchanged, worse)
Results:
One eye (3.3%) showed pathologic staining with fluorescein before CXL. One other eye 3 months after CXL, yet another eye 6 months after CXL, respectively.
Rose Bengal staining 3 and 6 months postoperatively was comparable to preoperative staining. The number of eyes with reduced tear-film break-up-time was not significantly changed. Three months after CXL, 10% of eyes had worse, and 16% of eyes had improved dry eye signs at slit-lamp examinations compared to preoperative findings. After 6 months, 20% of eyes were improved, and none deteriorated. Three months after CXL, 31% of eyes had worse, and 21% improved subjective symptoms of ocular dryness. After 6 months, 7% of eyes had worse, and 20% improved subjective symptoms of ocular dryness.
Conclusions:
We did not find a significant impact of CXL on ocular surface disease 3 and 6 months postoperatively.
Financial Disclosure:
No
