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Comparison of ocular discomfort after three different epithelial debridement techniques for corneal collagen cross-linking

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Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 16:02

Venue: Room 4.6

First Author: : D.Dursun Altınors TURKEY

Co Author(s): :    L. Asena   A. Yuce                 

Abstract Details


To compare the severity and duration of ocular discomfort after three different epithelial debridement techniques for corneal collagen cross linking (CCL).


Baskent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.


65 eyes of 54 patients (M/F:36/19) were included. CCL was performed after excimer laser transepithelial phototherapeutic keratectomy (PTK) in 18 eyes (Group 1), alcohol assisted epithelial removal in 27 eyes (Group 2) and mechanical epithelial debridement in 20 eyes (Group 3). Preoperative and postoperative BCVA, objective refraction and keratometry were recorded. Patients were contacted by telephone and asked about their subjective evaluation of postoperative sensations during the first week. Patients were asked to assign a score between 0-5 for each symptom and describe the duration. Paired samples t test and One-way ANOVA test were used for statistical analysis.


The Snellen BCVA increased from 0.51±0.27 to 0.58±0.21 (p=0.05). Kmax decreased from 57,63±4,73D to 56,13±4,47D (p=0.001). The mean score for foreign body sensation was highest in Group 3 (4.50±0.53) followed by Group 2 (2.71±1.97) and then Group 1 (2.10±1.85) (p=0.01). The mean scores for tearing, photophobia and burning sensation were all highest in Group 3 and lowest in Group 1, although not statistically significant. The duration of photophobia was shortest in Group 1 (1.50±2.37 days), followed by Group 3 (2.00±1.31 days) and then Group 2 (4.00±1.83 days) (p=0.04).


The severity and duration of subjective symptoms during the first postoperative week after CCL including foreign body sensation, tearing, photophobia and burning appear to be mildest with epithelial debridement by excimer laser transepithelial PTK followed by alcohol assisted epithelial debridement and worst after mechanical epithelial debridement.

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