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Preliminary clinical outcomes of corneal ectasia treatment with transepithelial cross-linking

Poster Details

First Author: D.Pinero SPAIN

Co Author(s):    A. Artola   P. Ruiz-Fortes   R. Pérez-Cambrodí   R. Soto-Negro     

Abstract Details



Purpose:

To evaluate visual, refractive and topography outcomes after transepithelial crosslinking treatment with the KXL system from Avedro in different types of corneal ectasia.

Setting:

Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain

Methods:

A total of 10 eyes of 8 patients with ages ranging from 26 to 69 years old were included (mean age: 46.6±15.2 years). All cases were diagnosed with corneal ectasia (9 eyes with keratoconus and one eye with post-LASIK ectasia) and showed signs of topographic and/or refractive progression. In all of them, transepithelial crosslinking surgery was performed using the KXL system from Avedro. Total irradiated energy was 7.2 J/cm2, ultraviolet power was 45 mW/cm2 and the treatment cycle was 2 seconds ON / 1 second OFF. The duration of irradiation was in all cases 4 minutes. Visual, refractive and topography (Pentacam system from Oculus) changes were evaluated at 3 months after surgery.

Results:

Mean spherical equivalent was reduced from a mean preoperative value of -1.96±3.60 D (range, -11.63 to +1.00 D) to a mean postoperative value of -1.48±2.93 D (range, -7.25 to +1.50 D), but the change did not reach statistical significance (p=0.30). The same trend was observed for manifest sphere (preop -0.18±3.62 vs. postop +0.61±3.39 D, p=0.20). Mean corrected distance visual acuity (CDVA) improved from a mean preoperative value of 0.45±0.32 logMAR (range, 0.00 to 1.00) to a mean postoperative vale of 0.30±0.35 logMAR (range, 0.00 to 1.00, p=0.17). There was a gain of lines of CDVA in 50% of eyes. No significant changes were detected in anterior and posterior keratometric readings (p≥0.45). The index of surface variation (ISV) was reduced from a mean preoperative value of 120.6±46.0 (range, 51 to 205) to a mean postoperative value of 110.6±32.6 (range, 49 to 153, p=0.13). The index of vertical asymmetry (IVA) was reduced from a mean preoperative value of 1.35±0.53 (range, 0.49 to 2.32) to a mean postoperative value of 1.19±0.35 (range, 0.47 to 1.54, p=0.19).

Conclusions:

Transepithelial corneal crosslinking is a safe technique for the management of progressive corneal ectasia, inducing some level of anterior corneal surface regularization and promoting an improvement in CDVA. Future studies including larger samples sizes and longer follow-up are still necessary in the future to confirm the trends observed in our series. FINANCIAL INTEREST: NONE

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