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Intraoperative OCT pachymetric mapping during accelerated pulsed high fluence corneal collagen cross-linking with dextran-free riboflavin

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Session Details

Session Title: Cross-linking I

Session Date/Time: Monday 15/09/2014 | 14:30-16:30

Paper Time: 15:42

Venue: Capital Hall A

First Author: : M.Rechichi ITALY

Co Author(s): :    S. Daya   M. Espinosa-Lagana   C. Mazzotta   R. Mencucci   A. Meduri   A. Spinelli

Abstract Details


To study in-vivo corneal pachymetric variations by spectral-domain optical coherence tomography (SDOCT) mapping during corneal pulsed accelerated collagen cross-linking (PACXL) treatment with the use of dextran-free riboflavin and ultraviolet A irradiation (UVA)


National Health System Eye Clinic


Thirty keratoconic patients (30 eyes) were enrolled. All patients underwent PACXL using a dextran-free riboflavin solution with hydroxypropyl methylcellulose. Intraoperative corneal pachymetric maps within central 5mm zone were obtained using SDOCT . Measurements were obtained at baseline, after epithelial removal, after 10 min riboflavin drop instillation, and after 8 minutes of pulsed irradiation at 30 Mw/cm2, 7.2 J


Mean patient age was 26.9±6.5 years (range, 17–40 years). Ten were male and 5 were female. Mean preoperative CCT was 437.5±21.5 μ (range, 520–370 μ); and 388.5±20.6 μ (range, 474–318 μ; before and after epithelial removal, respectively. There was a statistically significant decrease (mean, 75 μ) of CCT between the epithelial removal interval (415.7±20.6 μ; and at the end of riboflavin solution instillation (340.7±22.9 μ).There was no statistically significant change in CCT during irradiation (P>0.05). no statistically significant difference between preoperative and 1-month postoperative endothelial cell count was observed (preoperative, 2780±197 to 1-month postoperative, 2713±116; P = 0.14). No intraoperative, early postoperative, or late postoperative complications were observed in this patient series.


Intraoperative OCT showed that epi-off accellerated pulsed corneal CXL with the use of dextran-free riboflavin limits central and paracentral corneal thinning during the procedure. After epithelium removal a mild decrease of CCT was demonstrated only after irradiation phase.

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