Two year outcomes of randomised controlled trial comparing transepithelial corneal cross-linking with iontophoresis with standard protocol for the management of progressive keratoconus

Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 14:58

Venue: Room A3, Podium 3

First Author: : M.Lombardo ITALY

Co Author(s): :    S. Serrao   G. Lombardo                 

Abstract Details

Purpose:

To evaluate the 2-years follow-up clinical outcomes of transepithelial corneal cross-linking using iontophoresis (T-ionto CXL) in comparison with standard corneal cross-linking (standard CXL) for the treatment of progressive keratoconus.

Setting:

Studio Italiano di Oftalmologia, Rome (Italy).

Methods:

T-ionto CXL was performed by using an iontophoresis device with dextran-free 0.14% riboflavin-5-phosphate solution with enhancers and by irradiating the cornea with 10 mW/cm2 UV-A device for 9 minutes. Standard CXL was performed according to the Dresden protocol. Thirty-four eyes of 25 participants with progressive keratoconus were randomized into T-ionto CXL (22 eyes) or standard CXL (12 eyes). Assessment of corrected distance visual acuity (CDVA, LogMAR), manifest spherical equivalent refraction, maximum simulated keratometry (Kmax), corneal high-order aberration (HOA), central corneal thickness (CCT), and endothelial cell density (ECD) was performed.

Results:

Two years after T-ionto CXL and standard CXL, Kmax on average flattened by -1.05±1.20 D (P=0.07) and -1.51±0.89 D (P<0.001), respectively. The mean change in CDVA was -0.08±0.15 logMAR (P=0.04) and -0.02±0.06 logMAR (P=0.34) after T-ionto CXL and standard CXL, respectively. A significant average decrease in the myopic defocus (+0.81 D; P<0.05) was found in both groups. No significant differences in the outcome measures between treatments were found at 24 months. The corneal HOA, CCT and ECD measures did not change significantly in any group at 2 years.

Conclusions:

Clinically significant topographic, visual and refractive improvements were found 2 years after T-ionto CXL; the procedure has shown to be effective for the management of progressive keratoconus in subjects older than 21 years old.

Financial Disclosure:

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