Safety And Efficacy Of Accelerated Corneal Cross-Linking In Thin Corneas: A Comprehensive Study

Published 2024 - 42nd Congress of the ESCRS

Reference: PO664 | Type: Poster | DOI: 10.82333/b8ed-a814

Authors: Chiara Bonzano* ¹ , Laura Calabrese ¹ , Davide Borroni ² , Riccardo Scotto ³ , Carlo Alberto Cutolo ¹ , Carlo Enrico Traverso ¹

¹Eye Clinic, University of Genoa, and IRCCS San Martino Polyclinic Hospital,Genoa,Italy, ²RIGA STRADINS UNIVERSITY,Riga,Latvia, ³Eye Clinic, University of Genoa, and IRCCS San Martino Polyclinic Hospital,genoa,Italy

Purpose

This study aimed to evaluate the safety and reproducibility of accelerated corneal cross-linking (aCXL) in patients with thin corneas (<400 μm) compared to a control group with corneas above 400 μm. The study utilized the accelerated protocol and assessed anatomical, functional, and demarcation line outcomes.

Setting

Conducted at the Eye Clinic, University of Genoa, and IRCCS San Martino Polyclinic Hospital, Genoa, Italy, the study involved 32 patients with progressive keratoconus. Patients were divided into two groups based on corneal thickness: Group A (thin corneas <400 μm) and Group B (control, above 400 μm). The study monitored patients over an 18-month period with routine screenings and follow-ups.

Methods

Enrolled subjects (n=32), with 16 in each group, underwent comprehensive clinical assessments, including corneal topography, anterior segment optical coherence tomography (AS-OCT), in-vivo confocal microscopy, and slit-lamp examination to evaluate corneal changes. Visual function assessments were also conducted before and at 1, 3, 6, 12, and 18 months after aCXL. All treatments were performed using the epi-off technique with a hypotonic riboflavin solution, and demarcation line depth was measured using AS-OCT one month post-procedure.

Results

Among the 32 patients, 13 were females. The mean age was 19.5 ± 6.2 years (Group A) and 24.4 ± 5.54 years in Group B. Group A exhibited a preoperative mean corneal thickness of 369.73 μm ± 28.7 μm, while Group B showed 453.93 μm ± 17.1 μm. The mean demarcation line depth measured 249 μm ± 19.7 μm in thin corneas and 275.6 μm ± 27.5 μm in the control group. Both groups demonstrated stability in keratometry and corneal thickness at 18 months post-CXL (p < 0.001), accompanied by a significant reduction in the mean steepest keratometric reading, evident from three months after aCXL (p < 0.001) correlating with a slight reduction in anterior corneal astigmatism from baseline. No stromal haze or endothelium decompensation was observed.

Conclusions

Our study supports the effectiveness and safety of aCXL in patients with progressive keratoconus, including those with thin corneas, as indicated by the demarcation line depth in all treated corneas, while still adhering to the endothelial safety threshold.