Iontophoretic collagen cross-linking vs epithelium-off collagen cross-linking for early stage of progressive keratoconus: 4 year follow-up study

Session Details

Session Title: Cross-Linking

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

Paper Time: 15:20

Venue: Room A3, Podium 3

First Author: : A.Cantemir ROMANIA

Co Author(s): :    A. Alexa   R. Ciuntu   C. Danielescu   B. Galan   N. Anton   D. Chiselita     

Abstract Details

Purpose:

To compare 4-year iontophoretic corneal collagen crosslinking (I-CXL) outcomes with epithelium-off corneal collagen crosslinking (epi-off CXL) for early stage of progressive keratoconus.

Setting:

Oftaprof Clinic, Iasi, Romania

Methods:

Seventy-two eyes of 72 patients with early progressive keratoconus treated by I-CXL (n = 32) or epi-off CXL (n = 32) were included in this study. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, corneal topography, pachymetry and endothelial cell count were assessed at baseline and at 1, 3, 6, 12, 24, 36 and 48 months of follow-up. The demarcation line was asessed at 1 month postoperatively in all cases.

Results:

Visual acuity showed a significant improvement (P < .05) at the end of follow-up in both groups. The UDVA showed a more rapid recovery, after 3 months (P = .04), in the I-CXL group. The manifest cylinder improved beginning with 3 months after CXL in both group. Maximum keratometry showed a significant reduction in both CXL groups. Pachymetry values returned to preoperative levels at 12 months, while a statistically significant increase occurred in both groups at 24 months.Progression occurred to one patient in I-CXL group. Side effects occurred to eight eyes within the epi-off CXL group.

Conclusions:

Iontophoretic corneal collagen crosslinking is comparable to epi-off CXL for stopping the progression of early stage keratoconus with a higher degree of safety and a faster recovery of visual acuity.Because there is a risk of progression recurrence after a period of disease stabilization, these patients follow-up on long term is recommended.

Financial Disclosure:

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