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Corneal biomechanical and cell changes of four transepithelial corneal collagen cross-linking techniques in progressive keratoconus

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Session Details

Session Title: Cross-Linking

Session Date/Time: Sunday 06/09/2015 | 08:00-09:30

Paper Time: 08:57

Venue: Main Auditorium

First Author: : Q.Zeng CHINA

Co Author(s): :    M. Hu                    

Abstract Details


To evaluate early corneal biomechanical changes of four transepithelial corneal collagen crosslinking (TE-CXL) techniques in progressive keratoconus.


Zeng Qingyan, Hu Ming. Aier School of Ophthalmology, Central South University, Changsha, China, and Hankou Aier Eye Hospital, Wuhan, China.


Forty eyes of 40 keratoconus patients randomly divided into four groups were treated with different TE-CXL techniques: (A) application of hypo-osmolar riboflavin (Ricrolin TE) for 30 minutes; (B) riboflavin (Ricrolin+) application by iontophoresis for 5 minutes; (C) riboflavin (Ricrolin+) application by iontophoresis for 10 minutes. In these three groups UV-A treatment was performed at 10 mW/cm2 for 9 minutes. (D) application of riboflavin (ParaCel and VibeX Xtra) followed with pulsed light accelerated CXL (pl-ACXL) at 45 mW/cm2 for 2 minutes. Pre- and postoperative corneal densitometry, demarcation line, and corneal stroma were assessed using Pentecam HR, anterior-segment OCT and confocal microscopy.


The follow-up time was 6 months. The anterior 120 um layer corneal densitometry in the central 6 mm district increased postoperatively, reached summit at 7 days and then fell. The most significant increase were found in the 10 minutes iontophoresis group. Demarcation lines were detected in 90% 10 minutes iontophoresis group, 70% 5 minutes iontophoresis group, 40% pl-ACXL group and 40% hypo-osmolar riboflavin group; and the depth of demarcation line were 237 ± 45 um, 214 ± 45 um, 206 ± 47 um,144 ± 38 um, respectively (P= 0.01). Confocal microscopy revealed the apoptosis and activation of corneal stromal cells between 1 and 6 months, which was remarkable in 10 minutes iontophoresis group.


In these four TE-CXL techniques, 10 minutes iontophoresis seemed to induce most significant corneal biomechanical and cell changes, which was detected in standard epi-off CXL.

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