Iontophoresis corneal collagen cross-linking with and without epithelial debridement vs standard cross-linking: two year results of a prospective clinical study

Session Details

Session Title: Cross-Linking

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

Paper Time: 15:04

Venue: Room A3, Podium 3

First Author: : R.Vinciguerra ITALY

Co Author(s): :    P. Rosetta   E. Legrottaglie   E. Morenghi   S. Kaye   P. Vinciguerra        

Abstract Details

Purpose:

To compare the two years follow up outcomes of three groups of keratoconus patient treated respectively with transepithelial iontophoresis (I-CXL), iontophoresis with epithelial removal (I-SCXL) and standard-CXL (S-CXL) epithelium-off for progressive keratoconus.

Setting:

Humanitas Clinical and Research Center, Rozzano, Milan, Italy

Methods:

Sixty eyes of sixty patients treated with CXL for progressive keratoconus were included in this comparative prospective clinical study. Twenty patients were included in each group (I-CXL, I-SCXL and S-CXL). Corrected distance visual acuity (CDVA), refraction, corneal topography, Scheimpflug tomography and aberrometry were assessed at baseline and at 1, 3, 6, 12 and 24 months of follow up. To assess the long-term safety and efficacy of these treatments, the preoperative values were compared with the 24 months follow-up

Results:

The main outcome of the study was the non-statistically significant difference between the three protocols in the induced change in most of the parameters, including visual acuity (p=0.665), topographic indexes (all p>0.05) and Kmax (p=0.611) after 2 years of follow up. There were no significant differences in the change in refractive error following CXL in all groups or between groups (all p >0.05). Conversely, I-CXL induced significantly less corneal thinning (p=0.0299) and induced a significantly higher reduction of HOA and coma (both p<0.0001). All protocols induced a significant increase in visual acuity(S-CXL p=0.0004,I-SCXL p=0.0045 and I-CXL group p=0.004).

Conclusions:

The two years results of this comparative prospective clinical study demonstrate the efficacy and safety of transepithelial corneal cross-linking with iontophoresis to treat progressive keratoconus and overcome the limitations of CXL with epithelial debridement.

Financial Disclosure:

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