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Two years transepithelial corneal collagen cross-linking by Iontophoresis for progressive keratoconus: results

Poster Details

First Author: l.lapenna ITALY

Co Author(s):    L. Lapenna   F. Montrone                 

Abstract Details

Purpose:

To report two years results of Transepithelial collagen cross-linking by iontophoresis (I-CXL) of riboflavin in patients with progressive keratoconus (KC).

Setting:

Di Venere Hospital Bari, Italy

Methods:

I-CXL was performed in a series of 42 eyes of 34 patients with progressive keratoconus stage II-III of Amsler classification. Hypotonic riboflavin solution was administered for 5 minutes by iontophoresis, after which accelerated surface UVA irradiation  for 10 mW/cm nm, 3  (3702 ) was performed at a 5-cm distance for 9 minutes at 370 nm, 10 mW/cm2. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction , various corneal topography, anterior segment optical coherence tomography and endothelial cell count were evaluated at baseline and at 1, 3, 6,12 and 24 months.

Results:

Mean logarithm of the minimum angle of resolution baseline UCVA and BSCVA were 0.2 ± 0.21 and 0.1 ± 0.44, respectively. Mean UCVA and BSCVA at two years improved significantly of 54,8% and 42,8%, respectively. Only three of the patients (7%) showed a progression of keratoconus for up to 24 months. Mean spherical equivalent refraction showed a significant decrease of 1 diopter (D) at 24 months. Mean baseline Maximum keratometry decreased of 0.8 D at two years follow-up. Minimum corneal thickness values were stable for up to 24 months postoperatively. No pain and adverse side effects were reported. Endothelial cell counts did not change significantly.

Conclusions:

I-CXL of riboflavin seems to be a safe and effective procedure in stabilizing the progression of this disease combined with significant improvement of BCVA in patients with keratoconus. Results up to 2 year postoperatively indicate the efficacy of I-CXL as a valid alternative for halting the progression of keratoconus while reducing postoperative patient pain, risk of infection, and treatment time in select patients; however, the relative efficacy of this technique compared to standard epithelium-off techniques remains to be evalueted.

Financial Disclosure:

NONE

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