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Photorefractive intrastromal cross-linking (PiXL) with supplemental oxygen for reduction of myopia

Poster Details

First Author: M.Elling GERMANY

Co Author(s):    I. Kersten-Gomez   S. Taneri   B. Dick              

Abstract Details


To evaluate the safety and efficacy of a method for reduction of myopic refractive error in healthy myopic eyes through the targeted application of pulsed, accelerated corneal cross-linking in the presence of high oxygen.


Ruhr University Eye Hospital Bochum, Germany


Healthy volunteers with low myopia underwent the PiXL procedure without epithelial removal. Following pre-soak with 0.25% transepithelial riboflavin formulation, pulsed, accelerated cross-linking was applied over the central 4 mm of the cornea using a UVA delivery device with integrated pupil tracker. UVA dose ranged from 7.2 J/cm2 to 15 J/cm2. Efficacy evaluations included mean change in manifest refractive spherical equivalent (MRSE), uncorrected visual acuity (UCVA), and corneal curvature (Kmax, K Flat, and K Steep). Safety evaluations include best-corrected visual acuity (BCVA), slit lamp biomicroscopy, endothelial cell count and incidence of adverse events.


Preliminary analysis included 8 eyes. Improvement in UCVA was observed at 1 and 3 months postoperative. Mean improvement of 0.75 D (range 0.25 D to 1.37 D) in mean manifest spherical equivalent (MRSE) was observed. An endothelial cell count performed at 1 month postoperative showed there were no significant changes in cell density or number of cells.


PiXL is a promising method for reducing myopic refractive error in healthy eyes without epithelial removal or ablation. This method may be evaluated as an alternative to conventional refractive surgery. Longer follow-up is needed to determine the durability of the treatment effect.

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