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Comparison of 'epi-on' versus 'epi-off' cross-linking in progressive keratoconus

Poster Details

First Author: S.Mukherjee INDIA

Co Author(s):    S. Goel   N. Barua           

Abstract Details


To evaluate & compare the efficacy of “epithelium-on” to “epithelium off” cross linking.


: Anand hospital & Eye Centre, Jaipur , Rajasthan, India


Prospective study analyzed the UCVA at 6 months in 32 eyes with progressive keratoconus who had undergone collagen cross linking. 14 eyes underwent “epi-on” CXL & 18 eyes underwent conventional CXL. The two groups were analyzed on postoperative pain, UCVA, BSCVA, refraction, corneal topography, pachymetry evaluated at 1, 3 & 6 months postoperatively.


A comparison of epi-on with epi-off at 3 months showed that more than 50% and 30% of patients, respectively, had improvement in BSCVA of 1 line or more.Similar results were seen at 6 months (more than 50% of eyes in the epi-on group and more than 20% of eyes in the epi-off group demonstrated this level of improvement). The percentage of epi-on treated eyes with preoperative BSCVA of 20/30 or better increased from approximately 40% to more than 55% at 3 months and to more than 70% at 6 months. In the epi-off group, approximately 65% of patients had BSCVA of 20/30 or better; this percentage remained stable at 6 months after crosslinking. Postoperative pain without other complications was recorded.


Epi-on can be as effective as epi-off. Progression does not need to be seen to achieve results in uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and improvement in corneal shape. Patients of all ages, including those older than 35 years, can obtain results from crosslinking similar to those seen in younger patients.

Financial Disclosure:


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