I Kocak1, A Aydin2, F Kaya1, H Koc3. 1. Service d'ophtalmologie, hôpital de Nisa, Istanbul, Turkey. 2. Service d'ophtalmologie, hôpital de Nisa, Istanbul, Turkey; Clinique universitaire d'ophtalmologie, faculté de médecine, université d'Istanbul Medipol, Istanbul, Turkey. Electronic address: aliaydin67@hotmail.com. 3. Service d'ophtalmologie, hôpital de Kent, Kutahya, Turkey.
Abstract
PURPOSE: To evaluate the safety and efficacy of transepithelial corneal collagen crosslinking (TE-CXL) as compared to epithelium-off crosslinking (epi-off CXL) in progressive keratoconus. METHODS: Records of keratoconus patients treated with TE-CXL or epi-off CXL were reviewed retrospectively. Patients were included if they had at least 12months follow-up. Pre- and postoperative measurements of visual acuity, refractive errors, keratometry, corneal topography and pachymetry were assessed and compared. RESULTS: There was no statistically significant difference between two groups at baseline in terms of demographic, refractive and corneal parameters. Mean maximum cone apex curvature (apical K) increased from 51.62±5. Eighty-four diopters (D) to 53.70±5.49 D in the TE-CXL group (n=17), and decreased from 52.02±4.07 D to 51.22±3.51 in the epi-off CXL group (n=19) at the end of the follow-up period. The difference between two groups was statistically significant (P=0.0002). An increase of≥1D in apical K was observed in two of 19 eyes (11%) in the epi-off CXL group, and 11 of 17 eyes (65%) in TE-CXL group at the last follow-up visit, compared to baseline (P<0.0001). Fourteen patients in the epi-off CXL group exhibited corneal edema that resolved without haze with topical corticosteroid treatment by 4months. No postoperative corneal edema was observed in TE-CXL group. CONCLUSIONS: Although it is safe and well tolerated, TE-CXL does not effectively halt the progression of keratoconus. Epi-off CXL appears to be effective in stopping progression and even improves corneal parameters.
PURPOSE: To evaluate the safety and efficacy of transepithelial corneal collagen crosslinking (TE-CXL) as compared to epithelium-off crosslinking (epi-off CXL) in progressive keratoconus. METHODS: Records of keratoconus patients treated with TE-CXL or epi-off CXL were reviewed retrospectively. Patients were included if they had at least 12months follow-up. Pre- and postoperative measurements of visual acuity, refractive errors, keratometry, corneal topography and pachymetry were assessed and compared. RESULTS: There was no statistically significant difference between two groups at baseline in terms of demographic, refractive and corneal parameters. Mean maximum cone apex curvature (apical K) increased from 51.62±5. Eighty-four diopters (D) to 53.70±5.49 D in the TE-CXL group (n=17), and decreased from 52.02±4.07 D to 51.22±3.51 in the epi-off CXL group (n=19) at the end of the follow-up period. The difference between two groups was statistically significant (P=0.0002). An increase of≥1D in apical K was observed in two of 19 eyes (11%) in the epi-off CXL group, and 11 of 17 eyes (65%) in TE-CXL group at the last follow-up visit, compared to baseline (P<0.0001). Fourteen patients in the epi-off CXL group exhibited corneal edema that resolved without haze with topical corticosteroid treatment by 4months. No postoperative corneal edema was observed in TE-CXL group. CONCLUSIONS: Although it is safe and well tolerated, TE-CXL does not effectively halt the progression of keratoconus. Epi-off CXL appears to be effective in stopping progression and even improves corneal parameters.
Authors: Mohammed Iqbal Hafez Saleem; Hosam A Ibrahim Elzembely; Mortada Ahmed AboZaid; Mohammed Elagouz; Ahmed Mohamed Saeed; Osama Ali Mohammed; Ahmed Gad Kamel Journal: J Ophthalmol Date: 2018-01-17 Impact factor: 1.909