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Transepithelial cross-linking in treatment of severe epithelial and endothelial corneal dystrophias in geriatric patients

Poster Details

First Author: D.Povaliaeva RUSSIA

Co Author(s):    V. Egorov   G. Smoliakova   L. Danilova              

Abstract Details

Purpose:

The possibility of penetrating keratoplasty with epithelial-endothelial corneal dystrophy (EED) in geriatric patients is limited because of patients' age and concomitant serious medical condition. Therefore in treatment of these patients Ufa Institute of Ophthalmology proposes to use transepithelial crosslinking of cornea, inducing the formation of crosslinks between collagen molecules and directed to relief corneal and pain syndromes. The clinical assessment of results of use of this technology in ophthalmologic literature is presented still insufficiently. Purpose: evaluating the effectiveness of transepithelial crosslinking of corneal collagen in treatment of severe corneal EED in geriatric patients.

Setting:

Treatment of 11 patients (11 eyes) aged from 70 till 78 years was carried out. The reasons for the development of EED were: earlier carried out extraction of a cataract with implantation of IOL (4 eyes) and a consequence of the postponed post-herpetic uveitis (7 eyes).

Methods:

In all patients EED accompanied by diffuse edema, Descemet, recurrent corneal erosion and corneal and constant pain. Initial visual acuity in all patients ranged from light perception to 0.01. The technique of treatment of this group of patients included saturation of a cornea of 2% Riboflavinum solution within 10 minutes in the way of tray electrophoresis, followed by ultraviolet irradiation with apparatus "Ufalink". Total exposure time of the ultraviolet irradiation was 30 minutes. Observation terms – from 1 to 1,5 years.

Results:

Complete disappearance of conjunctival hyperemia, Descemet, corneal and pain syndromes were observed in all patients during the first 3 months after treatment. Decrease in corneal thickness to 560±15,6мкм against 790±18,5мкм initially was noted according pachymetry. By this time of observation pathological process characterized by complete epithelialization of the corneal surface with the formation of haze that patient didn’t feel subjectively. In one patient were not recorded cases of corneal recurrence and pain syndromes over the entire period of further observations (1-1.5 years). In 9 patients, there was an increase in visual acuity up to 0.05-0.09, the remaining 2 people visual acuity remained the same (light perception, 0.01).

Conclusions:

The study confirmed the therapeutic expediency of transepithelial crosslinking of the cornea, eliminating corneal and pain syndromes and improves the quality of life of geriatric patients with severe clinical manifestations EED of cornea.

Financial Disclosure:

NONE

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