Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study

• Published in: Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2014-01, Vol.8 (default), p.819-823
• Main Authors: Khairy, Hany A, Marey, Hatem M, Ellakwa, Amin Faisal
• Format: Article
• Language: English
• Subjects: Astigmatism; Biomechanics; Care and treatment; Cataracts; Collagen; Collagens; cross-linking; Crosslinking; Discomfort; Epithelium; Equivalence; Eyes; Family medical history; Keratoconus; Microscopy; Ophthalmology; Original Research; Patients; Physiological aspects; Polymer crosslinking; refractive surgery; Visual acuity; Vitamin B
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S60453

To evaluate the outcome of collagen cross-linking (CXL) without corneal epithelial debridement in patients treated for progressive keratoconus for whom the standard epithelium-off treatment cannot be applied, as their central corneal thickness (CCT) is less than 400 μm. This was a prospective, uncontrolled, interventional study involving 32 eyes of 30 patients with progressive keratoconus and CCT of less than 400 μm. All patients received CXL treatment with application of riboflavin and exposure to ultraviolet light A for 30 minutes without corneal epithelial debridement. Patients were followed up to 12 months postoperatively. The main outcomes were changes in maximum-K reading, manifest refractive spherical equivalent, CCT, and best-corrected visual acuity (logarithm of minimum angle of resolution). Patients were also asked to report any pain or discomfort during the procedure. At the end of the 12-month follow-up, CCT showed no significant change: from 392±5.17 μm preoperatively to 390±4.45 μm (P=0.102). Maximum-K reading decreased significantly, from 49.19±2.30 D preoperatively to 46.96±6.03 D postoperatively (P