Amsterdam 2013 Programme Satellite Meetings Registration Exhibition Virtual Exhibition Hotels Visa Letter Invitation
Search Abstracts by author or title
(results will display both Free Papers & Poster)

Epi-on vs epi-off corneal collagen cross-linking for keratoconus: in vivo comparative investigation by laser scanning confocal microscopy

Poster Details

First Author: C.Mazzotta ITALY

Co Author(s):    A. Paradiso   S. Baiocchi   T. Caporossi   A. Caporossi     

Abstract Details



Purpose:

Qualitative investigation of corneal micro-structural modifications in keratoconic patients undergoing Epi-Off standard and Epi-On experimental trans-epithelial cross-linking.

Setting:

Departement of Ophthalmology Siena University

Methods:

Prospective, observational open study on 20 patients with progressive keratoconus aged between 16 and 27 years (mean age 21 y). 10 patients at stage III KC, selected for Epi-On CXL had a corneal thickness in the range of 350-390 ?m at the thinnest point and 10 patients with corneal thickness over 400 ?m (range 401 - 490 ?m) measured by AC OCT system underwent Epi-Off cross-linking treatment. Epi-On CXL was performed by 0.1% riboflavin - 15% dextran solution supplemented with TRIS plus sodium EDTA and Epi-Off CXL with Riboflavin 0.1%-Dextran 20% solution according to Siena protocols. In vivo HRT II laser scanning confocal analysis.

Results:

After Epi-On CXL epithelial cells showed apoptosis with mosaic alterations gradually disappearing. Epithelium re-growth after Epi-Off was achieved after 3 days improving progressively. Keratocytes apoptosis in Epi-Off CXL was detected until 300 ?m of stroma while keratocytes apoptosis after Epi-On CXL was variable, superficial and uneven with a maximum depth of penetration at about 100 ?m in corneal stroma. Epi-On Treatment respected sub-epithelial and stromal nerves that did not disappear while the anatomy of the sub-epithelial plexus was restored one year after the operation. No variation in endothelial cell was observed in both procedures.

Conclusions:

In vivo confocal analysis showed a limited apoptotic affect of in Epi-On CXL, about one third of the Epi-Off CXL. The limited penetration correlated with limited biomechanical and clinical efficacy.

Financial Disclosure:

NONE

Back to previous