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Epi-Bowman’s keratectomy for cross-linking of keratoconus

Poster Details

First Author: D.Wajnsztajn ISRAEL

Co Author(s):    J. Frucht-Pery              

Abstract Details



Purpose:

To report our first experience of epithelium removal using Epi-Bowman’s Keratectomy with Epi Clear™ device, in standard corneal collagen crosslinking (CXL) procedure for keratoconus (KC).

Setting:

Hadassah Medical Center - Hebrew University Hospital, Ophthalmology Department, Jerusalem, Israel

Methods:

Ten patients with progressing KC (10 eyes) and 1 patient with progressing post-LASIK ectasia (1 eye) underwent standard CXL procedure according to the Dresden protocol, using hypotonic riboflavin and UVA exposure for 10 minutes (UV-X ™ Specifications, IROC, Zurich, Switzerland). The epithelium was removed with a novel Epi Clear™ device. After the procedure, a bandage contact lens (BCL) was placed and topical dexamethasone phosphate 0.1% X6 and topical gentamicin 0.3% X3 were prescribed. The corneal epithelial healing rate was observed at days 1, 3 and 7 post-CXL.

Results:

Eleven eyes of 11 patients underwent CXL with Epi-Bowman’s Keratectomy. Eight patients were male and 3 were female. Seven eyes were right and 4 were left eyes. Mean age was 24.8ḟ6.2 years (ranging from 16 to 33 years). Pre-treatment mean pachymetry was 455.3ḟ48.4?m (401 to 578?m) and mean topographic maximum keratometry was 52.2ḟ6.2D (47 to 68D). Using Epi Clear™ device, the epithelium was removed (slit-lamp) within 30 to 60 seconds to achieve an epithelial wound area of about 9mm. After 24 hours there was a significant epithelialization of about one third of the wound area. By day 3 all the corneas were fully epithelialized except one. This patient had BCL-induced red and painful eye with epithelial defect of 1x1mm. The BCL was removed. Signs and symptoms improved within 24 hours and the epithelialization was complete by day 7. There were no other complications.

Conclusions:

Epi-Bowman’s Keratectomy with the Epi Clear™ device for CXL was easy to perform. The epithelialization rate was fast. There were no Epi Clear™ device-related complications.

Financial Disclosure:

... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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