ESCRS - PP11.06 - Clinical Outcomes Of Transepithelial Corneal Crosslinking With Oxygen Boost For Early And Moderate Progressive Keratoconus; 6 Months Results.

Clinical Outcomes Of Transepithelial Corneal Crosslinking With Oxygen Boost For Early And Moderate Progressive Keratoconus; 6 Months Results.

Published 2022 - 40th Congress of the ESCRS

Reference: PP11.06 | Type: Free paper | DOI: 10.82333/4q3f-tk28

Authors: Alaa Eldanasoury* 1 , Emad Abdulazeem 1 , Ziad Zidan 1

1Ophthalmology,Magrabi Eye Hospitals and Centers,Jeddah,Saudi Arabia

Purpose

To assess refractive, topographic and high order aberration (HOA) changes 6 months after transepithelial cross-linking (T-CXL) with oxygen enrichment in eyes with early and moderate progressive keratoconus.

Setting

Magrabi Eye Hospital, Jeddah, Saudi Arabia.

Methods

Prospective study on 30 eyes of 30 consecutive patients with documented progressive keratoconus. All eyes received T-CXL with oxygen boost. Inclusion criteria included central corneal thickness of more than 400 µm, corrected distance visual acuity (CDVA) of 0.5 Logarithm of the Minimum Angle of Resolution (logMAR) or better and maximum keratometry (Kmax) of 60.0 D or less. Isotonic riboflavin 0.1% in hydroxypropyl methylcellulose and KXL ultraviolet-A (UVA) delivery system (Glaukos, CA, USA) were used for all eyes. Soaking time was 10 minutes, UVA exposure time was 10 minutes in pulsed mode with an average power of 30 mW/cm2 and total energy dose of 7.2 J/cm2. Oxygen concentration of 90% or above was maintained during the irradiation time.

Results

Mean age was 29.1 ± 4.7 yrs. At 6 months, follow up rate was 90%, no eye gained or lost 2 or more lines of CDVA. Mean change in CDVA was 0.02 ± 0.08 logMAR (p = 0.65), mean change in manifest refractive spherical equivalent (MRSE) was 0.09 ± 1.36 D (p = 0.75), mean vectoral change of astigmatism was -0.26 x 23.9º, mean change in Kmax was 0.15 ± 1.13 D (p = 0.94), mean change in central pachymetry was 4.69 ± 11.49 µm (p = 0.05), mean change in high order aberrations root mean square value (HO RMS) was 0.05 ± 0.29 µm (p = 0.43) and mean change in coma like aberrations was 0.02 ± 0.25 µm (p = 0.64). A demarcation line was documented in 60% eyes with a mean depth of 273 ± 40 µm. Trace stromal haze was observed in 36.7% eyes.

Conclusions

Accelerated T-CXL with oxygen boost is effective in halting the progression of early and moderate progressive keratoconus for at least 6 months. There is no statistically significant change in CDVA, MRSE, astigmatism, Kmax and HOA. Larger series and longer follow up are needed to confirm long term corneal stability.