ESCRS - PO673 - Assessment Of Accelerated Epi-Off Cross-Linking: A Multimodal Investigation Into Corneal And Retinal Outcomes In Progressive Keratoconus Patients

Assessment Of Accelerated Epi-Off Cross-Linking: A Multimodal Investigation Into Corneal And Retinal Outcomes In Progressive Keratoconus Patients

Published 2024 - 42nd Congress of the ESCRS

Reference: PO673 | Type: Poster | DOI: 10.82333/9sns-y696

Authors: Laura Calabrese 1 , Carlo Alberto Cutolo 1 , Aurora Schiavi 2 , Michele Iester 2 , Carlo Enrico Traverso 2 , Chiara Bonzano* 2

1DINOGMI,University of Genoa,Genoa,Italy, 2University of Genoa,Genoa,Italy

Purpose

Corneal collagen crosslinking (CXL) is a safe procedure for treating progressive keratoconus (KC). This study aims to identify any potential postoperative changes in foveal and parafoveal retinal thickness, superficial capillary plexus (SCP), deep capillary plexus (DCP), retinal nerve layer thickness (RNFL), ganglion cell complex (GCC), as well as in corneal parameters such as astigmatism, corneal curvature (K1 and K2), Central Corneal Thickness (CCT) and in optical biometry parameters such as axial length (AL), lens thickness (LT) and anterior chamber depth (ACD) in patients who underwent the accelerated epi-off cross-linking protocol (aCXL).

Setting

Our study was conducted at the Eye Clinic, University of Genoa, and IRCCS San Martino Polyclinic Hospital, Genoa, Italy.

Methods

Twenty-two eyes treated with epi-off aCXL were analyzed. A multimodal imaging assessment, including corneal topography (TMS-4N, Tomey), corneal pachymetry (RTVue-XR Avanti, Optovue), and biometry measurements (OA-2000, Tomey), was performed preoperatively and at one, three, and six months postoperatively, respectively. The superficial capillary plexus (SCP), deep capillary plexus (DCP), retinal nerve fiber layer thickness (RNFL), and the ganglion cell complex (GCC) were evaluated using optical coherence tomography angiography (OCTA) (DRI OCT Triton, Topcon) at each visit.

Results

Data from 22 eyes were included. The mean age was 27.7 ± 6.2 years, with 6 (27.2%) females. Corneal indexes exhibited a significant reduction at three months (p < 0.001) that remained stable at six months. No significant changes were detected in biometry measurements, and central corneal thickness remained unchanged. There was no significant difference in choroid capillary and SCP. A significant but minimal decrease in the DCP was observed, which returned to normal after 3 months. No significant change was detected in foveal or parafoveal retinal thickness. We observed a minimal increase in RNFL and GCC at 3 months.

Conclusions

Our study reinforces the safety and efficacy of aCXL for progressive keratoconus. Notable corneal changes, including reductions in meridian, apex, and asymmetry, are observed at three months. Transient alterations in the deep capillary plexus suggest the reversible nature of any impact on the retina. Optical and biometric parameters remain stable, affirming the procedure's safety. Minimal differences in retinal nerve layer and ganglion cell complex suggest positive long-term outcomes, potentially due to improved scans. These findings support accelerated epi-off cross-linking as a promising therapeutic avenue, emphasizing its safety and effectiveness in managing keratoconus.