Corneal Biomechanical Changes In Progressive Keratoconus After Two Novel Methods Of Oxygen-Supplemented Transepithelial Accelerated Crosslinking
Published 2025 - 43rd Congress of the ESCRS
Reference: PO480 | Type: Free paper | DOI: 10.82333/hv79-at21
Authors: Maria A. Henriquez* 1 , Denisse Aviles 2 , Claudia Pomatanta 2 , Rolando Rojas 2 , Jose Chauca 3 , Luis Izquierdo Jr 4
1Research Department,Oftalmosalud Institute of Eye,Lima,Peru;Faculty of Human Medicine,Universidad Ricardo Palma ,Lima,Peru, 2Research Department,Oftalmosalud Institute of Eye,Lima,Peru, 3Research Department,Oftalmosalud Institute of Eye,Lima,Peru;Department of Statistics, Demography, Humanities and Social Sciences,Universidad Peruana Cayetano Heredia,Lima,Peru, 4Research Department,Oftalmosalud Institute of Eye,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru
Purpose
To evaluate corneal biomechanical changes in progressive keratoconus (KCN) after two novel oxygen-supplemented transepithelial accelerated corneal crosslinking (O₂ epi-on CXL) techniques. Group 1 underwent O₂ epi-on CXL alone, while Group 2 received Topography-guided O₂ epi-on CXL.
Setting
This is a retrospective, single-center, non-randomized case series
Methods
This study included 26 progressive KCN eyes: 12 eyes (12 patients) underwent O₂ epi-on CXL (Group 1), and 14 eyes (12 patients) received topography-guided O₂ epi-on CXL (Group 2) (KXL II & Paracel, Glaukos, Burlington, USA). Corneal biomechanical changes were assessed preoperatively and at 6 months postoperatively using Corvis ST (Oculus, Wetzlar, Germany). Primary outcome measures included dynamic corneal response (DCR) parameters: deformation amplitude ratio (DA ratio), integrated radius (IR), stiffness parameters at A1 (SP-A1), and Stress Strain Index (SSI). Corneal stiffening was indicated by reduced DA ratio and IR, along with increased SP-A1 and SSI.
Results
At 6 months, paired t-tests of all 26 eyes showed significant corneal stiffening: DA ratio decreased (mean difference [MD] -0.40±0.49, p<0.001), IR decreased (MD -0.96±1.14, p<0.001), SP-A1 increased (MD +7.09±12.31, p=0.007), and SSI increased (MD +0.13±0.21, p=0.006). Only two eyes (17%) in Group 1 showed increased DA ratio, suggesting reduced rigidity. However, multivariate ANOVA revealed no significant differences in biomechanical improvements between Group 1 (O₂ epi-on CXL) and Group 2 (Topo-guided O₂ epi-on CXL) (p=0.371).
Conclusions
In our in-vivo biomechanical study with a dynamic Scheimpflug analyzer of 2 different oxygen-supplemented transepithelial accelerated CXL, significant corneal stiffening was observed at 6 months after both O2 epi-on CXL and Topo-guided O2 epi-on CXL. These findings support the efficacy of oxygen-supplemented transepithelial accelerated CXL in enhancing corneal rigidity of keratoconus patients.