Iontophoresis-Cxl For Young Early Keratoconus After Epithelium Off-Cxl In The Fellow Eye.

To assess the long-term outcomes of transepithelial iontophoresis cross-linking for early progressive keratoconus under the age of 25.

Humanitas San Pio X, Milan, Italy

Patients under the age of 25 who underwent to I-CXL for early progressive keratoconus were included in this retrospective study. The progression was based on the 95% CI of the Pentacam ABCD progression display and the second inclusion criterion was that the fellow, most advanced eye, had been treated with epithelium off CXL. CDVA, spherical equivalent, corneal topography and tomography indices were assessed at baseline and at least 24 months of follow up. Fifteen patients with a mean age of 17.6 ±3.50 months were included. The median follow-up time was 36 months. 

The statistical analysis showed no significant change over time in CDVA, maximum keratometry and A, B, C values of the Belin Progression Display. Mean baseline CDVA was 0,02±0,05 logMAR, whereas at 24-month was 0.00±0.00. Mean spherical equivalent was -1.35±1.55D at baseline and -1.05±1.71D after 24 months. Preoperative maximum keratometry was 47.45±3.54 D and 47.84±3.84 D after the 2 years follow-up. Mean baseline A value was 7.50±0.34 mm and 24-month postoperative was 7.52±0.37 mm. Average B value was 5,91±0,47 mm prior to surgery, while it was 5.88±0.57 mm after last follow-up. Mean baseline and 24-month thinnest point were 503.26±35.22 𝜇m and 504.26±34.06 𝜇m respectively. None of the patients showed a progression.

I-CXL is an effective and safe method to stabilize early progressive keratoconus with limited improvement noted. More studies will be needed to assess its long-term outcomes.