ESCRS - MP05 - A RANDOMISED CONTROL PROSPECTIVE STUDY TO INVESTIGATE THE EFFICACY OF TOMOGRAPHY-ORIENTATED VERSUS STANDARD AXIAL RIBOFLAVIN/ULTRAVIOLET A CORNEAL COLLAGEN CROSS-LINKING.

A RANDOMISED CONTROL PROSPECTIVE STUDY TO INVESTIGATE THE EFFICACY OF TOMOGRAPHY-ORIENTATED VERSUS STANDARD AXIAL RIBOFLAVIN/ULTRAVIOLET A CORNEAL COLLAGEN CROSS-LINKING.

Published 2022 - 26th ESCRS Winter Meeting

Reference: MP05 | Type: Abstracts | DOI: 10.82333/j42b-pr59

Authors: Khayam Naderi* 1 , Vivian Ho 2 , Nick Stanojcic 2 , Su-yin Kay 2 , Jack Gormley 2 , Scott Robbie 2 , Mani Bhogal 2 , Vijay Wagh 2 , Parul Patel 2 , David O'Brart 3

1Ophthalmology ,St.Thomas' Hospital ,London,United Kingdom;Diabetes and Nutritional Sciences ,King's College London,London,United Kingdom, 2Ophthalmology,St.Thomas' Hospital ,London,United Kingdom, 3Ophthalmology,St.Thomas' Hospital ,London,United Kingdom;Diabetes and Nutritional Sciences,King's College London,London,United Kingdom

Purpose

To compare the efficacy and safety of tomography-orientated riboflavin/ultraviolet A corneal collagen cross-linking with the standard axial epithelium-off technique to halt the progression of keratoconus. 

Setting

Single-centre, prospective, single-masked randomised case-controlled trial in a university hospital

Methods

 

18 eyes were randomised into the tomography-orientated group (TG) and 16 eyes were randomised into the standard treatment (ST) group. Patients were reviewed at baseline, and following cross-linking at 3 months, 6 months, 9 months, 12 months and 15 months. The main outcome measures were visual acuity (logMAR), refractive error, and corneal topographic keratometry. A paired t-test was used to compare pre- and post-operative outcomes and an unpaired t-test was used to compare variables between the two groups. 

Results

At 15 months, the mean (+/- standard deviation) maximum keratometry (Kmax) remained stable compared to baseline in both the TG group (57.39D (8.05) at 15 months vs 57.00D (7.10) at baseline, p=0.80), and the ST group (58.53D (7.95) vs 58.44 (7.82), p=0.72). Mean Keratometry (Kmean) also remained stable compared to baseline in the TG group (48.41D (4.13) vs 47.19 (3.61), p=0.30) and in the ST group (49.29 (5.37) vs 48.74 (4.78), p=0.13). The best-corrected visual acuity (with corrective spectacles) also remained stable at 15 months in both the TG (0.24 (0.20) vs 0.17 (0.18, p=0.39) and ST (0.26 (0.33) vs 0.30 (0.46), p=0.98) groups. Comparing the variables between the TG and ST groups at 15 months, there was no difference in KMax (p=0.71), Kmean (p=0.62), and BCVA (p=0.31). 

Conclusion

Our results indicate that both the tomography-guided (TG) and the standard (ST) axial epithelium-off technique halt the progression of keratoconus over a 15 month period.