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Individualized topopgraphy-guided crosslinking for keratoconus – comparison of epi-on in high oxygen to epi-off in room air protocols.
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First Author: A.Behndig SWEDEN
Co Author(s): S. Näslund
Abstract Details
Purpose:
To compare the efficacy, safety and healing phase of two different Customized Remodeled Vision (CuRV) crosslinking protocols for keratoconus.
Setting:
Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden.
Methods:
This ongoing study so far includes 15 patients at 12 month follow up with bilateral progressive keratoconus treated with bilateral CuRV; one eye with a high-oxygen epi-on protocol, the other eye with an epi-off protocol in room air, which was randomized and masked to the participant. Uncorrected (UDVA) and corrected visual acuities (CDVA), low-contrast visual acuities (LCVA) at 10% and 2.5%, refractive spherical equivalents (SE), keratometry readings (Kmax), endothelial cell count (ECC) and adverse events were analyzed pre- and post treatment. The discomfort symptoms during the healing phase for each eye was registered during the first week post treatment.
Results:
UDVA improved at 12 months (-0.30 ±0.36 logMAR for epi-on and -0.17 ± 0.25 logMAR for epi-off, (p<0.01), as did the 10% LCVA (-0.34 ± 0.46 and -0.16 ± 0.14, respectively, p<0.05), the 2.5 % in epi-on (-0.64 ± 0.92, p <0.05) and the CDVA (-0.15 ± 0.15, -0.11 ± 0.11, respectively, p <0.01). Kmax improved in both protocols (-2.44 ± 2.28, -1.29 ± 2.77 D, respectively, p <0.01).The epi-on eyes had less discomfort symptoms during the first week post-treatment. A slight reduction in ECC was noted in epi-off (-115 ± 225 cells/mm2, p < 0.05). No adverse events occurred.
Conclusions:
Our preliminary results indicate that the novel high-oxygen epi-on treatment protocol may be a promising alternative to epi-off CuRV. Inclusion of more patients and a longer follow up will show if this preliminary impression can be confirmed.
Financial Disclosure:
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