ESCRS - PO0612 - Utility Of Epithelial And Stromal Thickness Maps On Surgical Decision-Making For Corneal Collagen Crosslinking Procedure In Keratoconus Patients

Utility Of Epithelial And Stromal Thickness Maps On Surgical Decision-Making For Corneal Collagen Crosslinking Procedure In Keratoconus Patients

Published 2023 - 41st Congress of the ESCRS

Reference: PO0612 | Type: Free paper | DOI: 10.82333/tkr7-zn42

Authors: Maria A. Henriquez* 1 , Claudia Pomatanta 1 , Rolando Rojas 1 , Luis Izquierdo Jr. 1

1Research Department,Oftalmosalud Institute of Eyes,Lima,Peru

Purpose

To assess the effect on surgical decision-making for progressive keratoconus depending of an epithelial and stromal thickness map.

Setting

Research Department at Ofttalmosalud, Instituto de Ojos, Lima, Peru

Methods

A prospective and consecutive case series study was performed between January 2022 and January 2023. Patients with the thinnest pachymetry (TP) greater than 450um were assigned to epi-off CXL and to transepithelial CXL (T-CXL) to those with a TP less than 450um. Prior to surgery, an anterior segment OCT (MS-39) was performed, evaluating maximum epithelial thickness (MaxET) and minimum stromal thickness (MinST). Finally, the type of surgery was determined based on these variables: Epi-off CXL was indicated if MinST was equal to or greater than 400um, while T-CXL was indicated if MinST was less than 400 um. We evaluated the percentage of cases in which epithelial/stromal thickness data altered surgical decision-making.

Results

AS-OCT assessing epithelial and stromal thickness maps prior surgery, altered the surgeon’s decision making in 5.78% (10/173) of the cases (the procedure was change from Epi-off to transepithelial CXL). Mean MaxET in eyes undergoing corneal epi-off CXL was 55.28 +/- 4.3um (ranging from 44.3 to 67.8 um) and mean MinST was 418.39 (223 to 497 um). Transepithelial CXL is indicated in a greater quantity when using MinST than when using TP for surgical decision purposes. A significant negative correlation was found between MinST and MaxEP (r= -0.71, p = 004)

Conclusions

This study demonstrates the utility of stromal thickness maps for surgical decision-making in corneal collagen CXL for KC. The information gained from AS-OCT affects surgical decision-making in some patients.