First Author: G.Kymionis GREECE
Co Author(s): M. Grentzelos G. Kounis V. Diakonis
Purpose:
To compare the outcomes of corneal collagen crosslinking (CXL) for the treatment of progressive keratoconus using two different techniques for epithelial removal: transepithelial phototherapeutic keratectomy (t-PTK) versus mechanical epithelial debridement.
Setting:
: Institute of Vision and Optics (IVO), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
Methods:
In this prospective, comparative, interventional case series, 34 patients (38 eyes) with progressive keratoconus were enrolled. All patients underwent uneventful CXL treatment. Sixteen patients (19 eyes) underwent epithelial removal with t-PTK (group 1) and eighteen patients (19 eyes) underwent mechanical epithelial debridement with a rotating brush (group 2) during CXL treatment. Visual and refractive outcomes were evaluated along with corneal confocal microscopy findings preoperatively and at 1, 3, 6 and 12 months postoperatively.
Results:
There were no intraoperative or postoperative complications in any of the patients. In group 1, LogMAR mean UDVA and mean CDVA improved from 0.99±0.71 and 0.30±0.26 preoperatively to 0.63±0.42 (p=0.02) and 0.19±0.18 (p=0.008) at 12 months postoperatively, respectively. In group 2, mean UDVA and CDVA did not demonstrate a statistical significant improvement at 12 months postoperatively (p>0.05). In group 1, mean corneal astigmatism improved from -5.84±3.80 D preoperatively to -4.31±2.90 D (p=0.015) at last follow-up; while in group 2 there was no statistical difference at the same postoperative interval (p>0.05). No endothelial cell density alterations were observed throughout the follow-up period for both groups (p>0.05).
Conclusions:
Epithelial removal with t-PTK during CXL results in better visual and refractive outcomes in comparison with mechanical epithelial debridement.
Financial Disclosure:
No
