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Transepithelial corneal collagen cross-linking for progressive keratoconus

Poster Details

First Author: M.Panes BELARUS

Co Author(s):    S. Pozniak   N. Pozniak                 

Abstract Details

Purpose:

To evaluate the clinical and functional results and safety of transepithelial corneal collagen cross-linking (CXL) in patients with progressive keratoconus.

Setting:

Outpatient ophthalmic clinic. Ophthalmological department of Medical Centre of Minsk Tractor Plant,Minsk, Belarus

Methods:

Thirty-seven patients affected by bilateral progressive keratoconus were recruited. The worst eye was treated with transepithelial CXL, while the fellow eye was left untreated as a control. Transepithelial CXL was performed as follows: miosis was induced by applying drops of pilocarpine 1%; local anesthetic was induced by applying drops of tetracaini 1%; using a solution of riboflavin 0.2% with NaCl, boric acid, glycerol, methyl cellulose, EDTA (ethylenediaminetetraacetic acid), sodium tetraborate (pH 7.4) on the intact corneal epithelium for 30 minutes, after which standard surface UVA irradiation (370 nm, 3 mW/cm(2) ) was performed for 30 min.

Results:

In treated eyes, there were statistically significant improvements in uncorrected and corrected distance visual acuity (UDVA, CDVA) one year after the procedure (on the average on two lines for UDVA and three lines for CDVA). Corneal astigmatism decreased from – 4.7 ± 3.1 to – 2,2 ± 2.9 D. There were no statistically significant differences in the changes of mean spherical equivalent, pakhimetry and keratometry indicators. In untreated control eyes, there was a general trend towards worsening of these parameters. Preoperative and postoperative endothelial cell density remained unchanged. The corneal stromal demarcation line was identified in some eyes.

Conclusions:

Transepithelial CXL applying an enhanced riboflavin solution (riboflavin 0.2%, NaCl, boric acid, glycerol, methyl cellulose, EDTA) is a safe and affective method in the treatment progressive keratoconus. This method is effective to halt keratoconus progression, with a statistically significant improvement in visual functions.

Financial Disclosure:

NONE

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