Epi-Off Customized Crosslinking With And Without Supplementary Oxygen - 1 Year Results
Published 2022
- 40th Congress of the ESCRS
Reference: PP11.07
| Type: Free paper
| DOI:
10.82333/3733-8256
Authors:
Theo G. Seiler* 1
, Kaspar Schürch 2
, Beatrice Frueh 2
1University Hospital Düsseldorf,Düsseldorf,Germany;Inselspital Bern,Bern,Switzerland, 2Inselspital Bern,Bern,Switzerland
Purpose
To evaluate potential advantages of supplemental oxygen in of epi-off customized CXL.
Setting
Prospective observational study at the Department of Ophthalmology, University Hospital Bern, Switzerland
Methods
Forty eyes of 40 patients with documented progressive keratoconus were treated with epi-off customized CXL using 15 mW/cm2 and maximal energy levels of 10 J/cm2. Twenty eyes were treated in an atmospheric (21% O2) environment, while 20 eye were treated in a hyperoxic environment (>90% O2) and followed for 1 years. Analyzed parameters were Scheimpflug tomographies, endothelial cell count, BSCVA and anterior segment OCT.
Results
Keratoconus progression was halted in all eyes. Kmax regression in the supplemental oxygen subgroup was significantly greater compared to the normoxic subgroup (-3.4 vs. -0.8 D). High flattening (>4D) was observed in 8 eyes (40%) in the hyperoxic vs. 1 eyes (5%) in the normoxic subgroup. BSCVA increased in both groups, however, significantly more in the supplementary oxygen subgroup. Densitometry peaked in both groups by month 3 and reached preoperative values in the normoxic subgroup, but not completely in the supplementary oxygen subgroup. Demarcation lines were observed significantly deeper using CXL with supplemental oxygen (334 vs 230 microns).
Conclusions
Supplementary oxygen optimizes the effect and outcome of epi-off CXL with 15mW/cm2. Flattening, corneal regularization and visual acuity improvement go along with an increased haze formation and deeper demarcation line depth using supplemental oxygen.