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Safety and efficacy of high-fluence CXL for progressive keratoconus: short-term results

Poster Details

First Author: Z.Gatzioufas SWITZERLAND

Co Author(s):    O. Richoz   D. Tabibian   F. Hafezi        

Abstract Details



Purpose:

To evaluate the efficacy and safety profile of high-fluence epi-off CXL treatment for progressive keratoconus (KC), with regard to corneal topography and endothelial cell integrity.

Setting:

Department of Ophthalmology, Geneva University Hospitals HUG, Geneva, Switzerland

Methods:

Prospective interventional case series of 10 human eyes with progressive KC, which underwent epi-off CXL with high-fluence (18 mW/cm2). CXL was performed according to the Dresden protocol with modifications. Corneal epithelium was removed mechanically over the central 8 mm. Isotonic riboflavin 0.1% drops (PESCHKE; Meditrade GmbH, Huenenberg, Switzerland) were instilled every 2 minutes for 30 minutes. Afterwards, the corneas were exposed to ultraviolet-A light (UV-X System; Peschke Meditrade GmbH, Huenenberg, Switzerland) for 5 minutes with a wavelength of 370 nm and in a dosage of 18 mW/cm2. Administration of additional isotonic riboflavin drops occurred every 2 minutes during the ultraviolet-A exposure. Kmax and corneal thickness at thinnest point were evaluated by Scheimpflug imaging (Pentacam HR, Oculus, Wetzlar, Germany) at 1 month pre-operatively, as well as at 1 month and 3 months postoperatively. Endothelial cell density was measured by scanning-laser confocal microscopy (HRT cornea module, Heidelberg Engineering, Heidelberg, Germany) in the same intervals. Corrected Distance Visual Acuity (CDVA) was also evaluated.

Results:

Preoperative endothelial cell density (ECD) was 2942ḟ85 cells/mm2, whereas ECD was 2918ḟ78 cells/mm2 and 2912ḟ82 at 1 and at 3 months postoperatively, respectively. The differences were not statistically significant (all p>0.05, Fisher‘s exact test). Likewise, mean Kmax was decreased from 55,6ḟ3,4 dpt preoperatively to 54,6ḟ4,2 dpt at 1 month postoperatively and 54,1ḟ3,9 at 3 months postoperatively, but the differences were not statistically significant (all p>0.05, Fisher’s exact test). Best-corrected distance visual acuity (BCVA) (logMAR) improved from 0,37ḟ0,22 preoperatively to 0,48ḟ0,34 at 1 month postoperatively and to 0,49ḟ0,42 at 3 months postoperatively. The differences were not statistically significant (all p>0.05, Fisher’s exact test).

Conclusions:

High-fluence epi-off CXL treatment for progressive KC did not affect significantly the ECD at 1 month. Mean Kmax decreased and BCVA improved, but the differences were not statistically significant. No other complications occurred during this short-term follow-up period. Further follow-up is required for validating these results.

Financial Disclosure:

NONE

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