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First Author: D.Wajnsztajn ISRAEL
Co Author(s): J. Frucht-Pery
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To report our first experience of epithelium removal using Epi-Bowmans Keratectomy with Epi Clear device, in standard corneal collagen crosslinking (CXL) procedure for keratoconus (KC).
Hadassah Medical Center - Hebrew University Hospital, Ophthalmology Department, Jerusalem, Israel
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.
Eleven eyes of 11 patients underwent CXL with Epi-Bowmans 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.
Epi-Bowmans 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.
... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented