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Transepithelial vs epithelium-off CXL for progressive keratoconus: long-term results

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Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 15:38

Venue: Room A3, Podium 3

First Author: : M.Alfayez SAUDI ARABIA

Co Author(s): :    O. Alfayez                    

Abstract Details


To compare the long-term safety and efficacy of transepithelial with epithelium-off corneal cross-linking for progressive keratoconus.


King Abdulaziz University Hospital and The Eye and Last Centre.


In a prospective clinical trial, 96 patients with progressive keratoconus were randomized to undergo corneal cross- linking with intact epithelium (n = 46) or after deepithelialization (n = 50). The main outcome measure was a change in the maximum K reading (K(max)).


With 5-year follow-up, K(max) decreased in the epithelium-off group with a mean of 2.5 D and no patient showed evidence of progression. In the transepithelial group, K(max) increased by a mean of 1.4 D, and 24 patients (52%) showed progression of keratoconus.


In this study, epithelium-off was significantly more effective than transepithelial corneal cross-linking in halting the progression of keratoconus (P < 0.0001).

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