Leopoldo Spadea1, Lucia Di Genova2, Emanuele Tonti2. 1. From the Department of Biotechnology and Medical-Surgical Sciences, Sapienza University of Rome, Terracina (Latina), Italy. Electronic address: leopoldo.spadea@uniroma1.it. 2. From the Department of Biotechnology and Medical-Surgical Sciences, Sapienza University of Rome, Terracina (Latina), Italy.
Abstract
PURPOSE: To use anterior segment optical coherence tomography (AS-OCT) to compare corneal stromal demarcation line depth after 4 treatment protocols of corneal crosslinking (CXL). SETTING: Eye Clinic, Sapienza University of Rome, Terracina (Latina), Italy. DESIGN: Prospective case series. METHODS: Patients with progressive keratoconus were delegated to one of the following CXL treatments: (1) conventional epithelium (epi)-off 3 mW/cm2 according to the standard Dresden protocol (C-CXL group), (2) accelerated epi-off 10 mW/cm2 (A-CXL group), (3) transepithelial epi-on 3 mW/cm2 (TE-CXL group), or (4) transepithelial epi-on by iontophoresis 10 mW/cm2 (I-CXL group). Two independent observers measured the corneal stromal demarcation line using AS-OCT. RESULTS: The study comprised 70 patients (120 eyes, 30 eyes in each group). The corneal stromal demarcation line was identified on AS-OCT scans in 109 eyes (90.8%). One month after the treatment, the mean stromal demarcation line depth was 275.05 μm ± 41.83 (SD) in the C-CXL group, 279.35 ± 33.07 μm in the A-CXL group, 132.60 ± 22.14 μm in the TE-CXL group, and 235.40 ± 37.08 μm in the I-CXL group. The difference in stromal demarcation line depth was not statistically significant between the C-CXL and A-CXL group, but it was statistically significant (P < .05) between the epi-off and epi-on CXL groups and between the 2 epi-on groups, where the demarcation line was significantly deeper in the I-CXL group than in the TE-CXL group. CONCLUSION: The corneal stromal demarcation line was significantly deeper after epi-off 30-minute standard CXL treatment and after epi-off 9-minute accelerated CXL with high-intensity ultraviolet-A irradiation.
PURPOSE: To use anterior segment optical coherence tomography (AS-OCT) to compare corneal stromal demarcation line depth after 4 treatment protocols of corneal crosslinking (CXL). SETTING: Eye Clinic, Sapienza University of Rome, Terracina (Latina), Italy. DESIGN: Prospective case series. METHODS:Patients with progressive keratoconus were delegated to one of the following CXL treatments: (1) conventional epithelium (epi)-off 3 mW/cm2 according to the standard Dresden protocol (C-CXL group), (2) accelerated epi-off 10 mW/cm2 (A-CXL group), (3) transepithelial epi-on 3 mW/cm2 (TE-CXL group), or (4) transepithelial epi-on by iontophoresis 10 mW/cm2 (I-CXL group). Two independent observers measured the corneal stromal demarcation line using AS-OCT. RESULTS: The study comprised 70 patients (120 eyes, 30 eyes in each group). The corneal stromal demarcation line was identified on AS-OCT scans in 109 eyes (90.8%). One month after the treatment, the mean stromal demarcation line depth was 275.05 μm ± 41.83 (SD) in the C-CXL group, 279.35 ± 33.07 μm in the A-CXL group, 132.60 ± 22.14 μm in the TE-CXL group, and 235.40 ± 37.08 μm in the I-CXL group. The difference in stromal demarcation line depth was not statistically significant between the C-CXL and A-CXL group, but it was statistically significant (P < .05) between the epi-off and epi-on CXL groups and between the 2 epi-on groups, where the demarcation line was significantly deeper in the I-CXL group than in the TE-CXL group. CONCLUSION: The corneal stromal demarcation line was significantly deeper after epi-off 30-minute standard CXL treatment and after epi-off 9-minute accelerated CXL with high-intensity ultraviolet-A irradiation.
Authors: B Seitz; L Daas; L Hamon; K Xanthopoulou; S Goebels; C Spira-Eppig; S Razafimino; N Szentmáry; A Langenbucher; E Flockerzi Journal: Ophthalmologe Date: 2021-06-28 Impact factor: 1.174