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Comparing the effect of corneal collagen cross-linking in progressive KCN via epithelium removal and transepithelial, using DAYA epithelium disruptor: a randomised controlled clinical trial

Poster Details

First Author: S.Zaheryany IRAN

Co Author(s):    H. Movahhedan   R. Salouti   S. Bamdad   S. Mohaghegh   S. Javadpour        

Abstract Details


To compare the effect of corneal collagen cross-linking (CXL) in progressive keratoconus patients via epithelium removal and transepithlial, using DAYA Epithelium Disruptor.


Khalili hospital of Shiraz University of Medical Sciences


In a double-blinded randomized clinical trial, sixty eight eyes from thirty four patients with progressive keratoconus were included. In each patient one eye underwent epithelium removal (group1) procedure and the fellow eye underwent DAYA epithelium disruptor (group2) procedure. Mean follow-up duration was 6 months. Primary outcomes were uncorrected (UCVA) and best spectacle-corrected visual acuities (BSCVA), schimpflug-extracted keratometric indices and pachymetry, and anterior segment ocular coherence tomography (OCT)-derived epithelial thickness profile. Secondary outcomes were higher order aberrations (HOA) extracted from scheimpflug imaging.


Mean age of the patients were 23.3 ± 3.6 years. There was a statistically significant changes at base line and 6 months after treatments in UCVA (group1 1 D, group2 1.2 D), flat k (group1 0.2 D, group2 0.18 D), astigmatism (group1 0.57 D, group2 0.43 D), cornral thikness (group1 25 µm, group2 13 µm) and root-mean-square of (RMS-HOA) (group 1 -0.8 and group 2 -0.49) in both methods. Only, Difference in changes of corneal thickness was statistically significant between two methods, p-value ˂ 0.0001.


: Both groups acheived significant improvement in UCVA, flat K, astigmatism and RMS-HOA values after 6 months follow-up. This study shows that DAYA disruptor procedure is as effective as epithelium removal procedure with the advantage of less decrease in corneal thickness. It seems that this method differs from other types of transepithelial-CXL, which epithelium is left intact in them.

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