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One year outcomes of corneal ectasia treatment with accelerated transepithelial cross-linking

Poster Details

First Author: D.Piñero SPAIN

Co Author(s):    A. Artola   P. Ruiz-Fortes   R. Perez-Cambrodi   R. Soto-Negro           

Abstract Details


To evaluate visual, refractive, corneal topographic and aberrometric outcomes after transepithelial crosslinking treatment with the KXL system from Avedro in different types of corneal ectasia during a 1-year period after surgery.


Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain


A total of 21 eyes of 14 patients with ages ranging from 26 to 69 years old were included. All cases were diagnosed with corneal ectasia (19 eyes keratoconus, 2 eyes post-LASIK ectasia) and showed signs of progression. In all cases, transepithelial crosslinking surgery was performed using the KXL system from Avedro. Total irradiated energy was 7.2 J/cm2, ultraviolet power was 45 mW/cm2 and the treatment cycle was 2 seconds ON / 1 second OFF. Riboflavin penetration was evaluated by optical coherence tomography immediately after surgery. Visual, refractive, corneal topographic and aberrometric changes were evaluated at 12 months after surgery.


Mean spherical equivalent was reduced from -1.79±2.86 to -1.41±1.98 D (p=0.37). Mean corrected distance visual acuity (CDVA) improved significantly from 0.34±0.18 to 0.22±0.24 logMAR (p=0.01). There was a gain of lines of CDVA in 15 eyes (71.43%). A small but statistically significant reduction was detected in anterior keratometry (p=0.04), but not in the posterior reading (p=0.44). A no statistically significant reduction was observed in root mean square for anterior (3.51±1.53 vs 3.26±1.04, p=0.30) and posterior (0.95±0.4 vs 0.85±0.43, p=0.37) higher order aberrations. Mean riboflavin penetration was 203.38±21.18 µm.


Transepithelial corneal crosslinking is a useful technique for the management of progressive corneal ectasia, inducing some level of anterior corneal surface regularization that generates an improvement in CDVA. The level of riboflavin penetration achieved with this modality of crosslinking is lower than that obtained with classical crosslinking.

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