Biomechanical Change Between Klex Surgery With And Without Cxl

To evaluate clinical effectiveness of Epi-on Cross linking during KLEX surgery.

Fatima Eye Clinic, Changwon, South Korea

Fatima Eye Research, Changwon, South Korea

Total 282 KLEX eyes and the 37 KLEX+ eyes were enrolled in this study. Eventful surgery were excluded. In addition to clinical data such as spherical equivalent (SE) and central corneal thickness (CCT),  corneal biomechanical data, measured on a Brillouin Optical Scanning System (BOSS, Intelon Optics), were compared preoperatively and 1-month , 3months postoperatively for KLEX and KLEX+ patients. Binocular KLEX was performed with either the Visumax 500 or 800. Epi-on cross-linking modulated by surgeon’s own protocol was performed. Parametric or non-parametric analyses were used, as appropriate.

There were no significant differences between two groups in terms of patient age, sex, IOP or Pentacam K_mean (Km) at baseline (P≥0.06).  There were no baseline differences between groups in the 4 BOSS parameters (Central, Mean, Min and MAX Brillouin moduli (BM), P≥0.48). The KLEX+ group showed greater drops in IOP and greater increases in SE at 1 month than the KLEX group (P=0.02 and 0.0009, respectively); the decrease in Km was also greater for the KLEX+ group. The Brillouin moduli were significantly greater at 1 month for the KLEX+ group than the KLEX (P≤0.01) and the changes (1-month − preop) were more-positive (P≤0.03). Postoperative 3months data will be added.

: Despite the thicker lenticules and thinner baseline corneal thickness in the KLEX+ group, at 1 month after surgery, the KLEX+ values showed less decrease in stiffness, or even some increase, resulting in greater stiffnesses at that time for the KLEX+ group. Therefore, the addition of CXL reduced the decrease in stiffness observed after KLEX in these patients.