Prospective Study Of The Impact Of Oxygen Supplementation On The Outcomes Of Accelerated Transepithelial Corneal Cross-Linking In Progressive Keratoconus: A Case Series Of 50 Patients

This study evaluates the efficacy of accelerated CXL in pulsed mode with periocular oxygen supplementation in stabilizing keratoconus, focusing on its impact on corneal topographic and visual outcomes.

Accelerated trans-epithelial corneal cross-linking (CXL) using pulsed mode with periocular oxygen supplementation represents an advanced therapeutic approach for stabilizing keratoconus. Preliminary evidence suggests that this method may offer enhanced stabilization compared to traditional CXL techniques.

A prospective, comparative study was conducted in the Ophthalmology Department B at Rabat Specialty Hospital. The study compared the efficacy of transepithelial (epi-on) CXL with oxygen supplementation (Group B) versus the same protocol without oxygen enrichment (Group A) over a 12 months follow-up period.

At 12 months, significant stabilization of maximum keratometry was observed in Group A, with further improvement noted in Group B. Group A experienced slight improvement in best corrected visual acuity. The method also showed promising effects on corneal thickness in Group A.

The study results align with existing literature, showing that oxygen supplementation can improve keratometric values and visual acuity. The use of oxygen may enhance the photosensitizer response to riboflavin and optimize CXL efficacy. Adapting clinical measures to promote an oxygen-rich environment could maximize cross-linking outcomes.

Oxygen supplementation during epi-on CXL represents a promising therapeutic approach for managing keratoconus. However, further large-scale, prospective, randomized, controlled studies with extended follow-up are necessary to refine this technique and fully elucidate its benefits and limitations.