Correlation Of Depth Of Demarcation Line With Wavefront Abnormalities In Post-Collagen Cross-Linking Cornea
Published 2025 - 43rd Congress of the ESCRS
Reference: FP03.11 | Type: Free paper | DOI: 10.82333/y2p4-k704
Authors: Jacob Megreli* 1 , Olga Reitblat 1 , Noa Kapelushnik 2 , Guy Gindis 3 , Uri Elbaz 1 , Ruti Sella 4 , Irit Bahar 1 , Eitan Livny 1
1Department of Ophthalmology,Rabin Medical Center,Petah Tikva,Israel;Faculty of Medical & Health Sciences ,Tel Aviv University,Tel Aviv,Israel, 2Department of Ophthalmology,Rabin Medical Center,Petah Tikva,Israel, 3Faculty of Medical & Health Sciences ,Tel Aviv University,Tel Aviv,Israel, 4Department of Ophthalmology,Mayo Clinic,Rochester, Minnesota,United States
Purpose
To evaluate the correlation between the demarcation line depth (DL) and wavefront abnormalities in corneas after collagen cross-linking (CXL) for progressive keratoconus.
Setting
Prospective observational study conducted at a tertiary care centre in Maharashtra, India involving patients with progressive keratoconus who underwent standard epithelium-off CXL.
Methods
Patients diagnosed with progressive keratoconus were included in this study.Patients with history of previous ocular surgery, parameters posing as a contraindication of CXL like corneal thickness less than 400 um or co-existing ocular comorbidities were excluded from the study.All patients underwent standard epithelium-off CXL.Corneal tomography and aberrometry were performed preoperatively and at 3 and 6 months postoperatively using Sirius Corneal Topography(CSO, Italy) and Lenstar 900 (Haag-Streit Diagnostics, Switzerland). The depth of the demarcation line was measured using anterior segment optical coherence tomography (AS-OCT) at 1 month. Higher-order aberrations (HOAs) were analysed using wavefront aberrometry.
Results
108 patients were enrolled in this study with 52 (48%) males and 56(51.85%) females. The average age of patients was 18.52 ± 2.6.The mean depth of the demarcation line was found to be 210 ± 10.82 µm. A significant correlation was observed between greater DL depth and a reduction in total HOAs (p < 0.05). Coma aberration demonstrated the strongest correlation (p < 0.01). Eyes with a shallower DL depth exhibited less improvement or even worsening of wavefront abnormalities postoperatively. A significant correlation was observed between greater DL depth and a reduction in total Higher order aberrations.
Conclusions
A deeper demarcation line following CXL is associated with more significant improvements in corneal wavefront abnormalities, particularly coma aberration. Although, the depth of demarcation line serves as an optical coherence tomography biomarker for efficacy of CXL procedure, this research represents the first exploration of the correlation between wavefront abnormalities and the depth of the demarcation line, a relationship that has not been previously adequately addressed in the existing literature.