Shaowei Li1,2, Huatao Xie3, Man Xu4, Meiyan Li5, Chang Liu4, Jingliang He6,4, Tian Han5, Xingtao Zhou7. 1. Aier School of Ophthalmology, Central South University, Changsha, 410015, China. lishaowei@csu.edu.cn. 2. Beijing Aier Intech Eye Hospital, Beijing, 100000, China. lishaowei@csu.edu.cn. 3. Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. 4. Beijing Aier Intech Eye Hospital, Beijing, 100000, China. 5. Myopia Key Laboratory of the Health Ministry, Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China. 6. Aier School of Ophthalmology, Central South University, Changsha, 410015, China. 7. Myopia Key Laboratory of the Health Ministry, Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, 200031, China. doctzhouxingtao@163.com.
Abstract
PURPOSE: To compare the postoperative pain and epithelial healing time in conventional and subepithelial accelerated corneal collagen cross-linking (CXL) for progressive keratoconus. METHODS: The medical records of 27 consecutive patients who underwent accelerated CXL for progressive keratoconus were retrospectively reviewed. Patients were divided into two groups: the conventional (n = 16) and the subepithelial accelerated CXL group (n = 11). Corneal epithelial layers with a diameter of 8.5 mm in central corneas were removed in the conventional group, while epithelial flaps with the same diameter were prepared in the subepithelial group before accelerated CXL procedures. Postoperative pain and epithelial healing time were evaluated within 1 week. RESULTS: No complications developed in the subepithelial group, whereas peripheral corneal sterile infiltrate was observed in three eyes in the conventional group, which disappeared after treated with steroids for a week. The pain of patients in subepithelial group was significantly slighter than those in conventional group, with a significant difference in pain scoring 0, 1, 2 and 3 days postoperatively (P = 0.002, P = 0.001, P = 0.001, P = 0.001, respectively). Different from the fact that patients in subepithelial group had epithelium after operation, the healing time for epithelium in conventional group was 3-6 days, with an average of 4.64 ± 0.59 days. CONCLUSIONS: Subepithelial accelerated CXL significantly improved postoperative pain as well as reduced the epithelial healing time for the treatment of keratoconus.
PURPOSE: To compare the postoperative pain and epithelial healing time in conventional and subepithelial accelerated corneal collagen cross-linking (CXL) for progressive keratoconus. METHODS: The medical records of 27 consecutive patients who underwent accelerated CXL for progressive keratoconus were retrospectively reviewed. Patients were divided into two groups: the conventional (n = 16) and the subepithelial accelerated CXL group (n = 11). Corneal epithelial layers with a diameter of 8.5 mm in central corneas were removed in the conventional group, while epithelial flaps with the same diameter were prepared in the subepithelial group before accelerated CXL procedures. Postoperative pain and epithelial healing time were evaluated within 1 week. RESULTS: No complications developed in the subepithelial group, whereas peripheral corneal sterile infiltrate was observed in three eyes in the conventional group, which disappeared after treated with steroids for a week. The pain of patients in subepithelial group was significantly slighter than those in conventional group, with a significant difference in pain scoring 0, 1, 2 and 3 days postoperatively (P = 0.002, P = 0.001, P = 0.001, P = 0.001, respectively). Different from the fact that patients in subepithelial group had epithelium after operation, the healing time for epithelium in conventional group was 3-6 days, with an average of 4.64 ± 0.59 days. CONCLUSIONS: Subepithelial accelerated CXL significantly improved postoperative pain as well as reduced the epithelial healing time for the treatment of keratoconus.
Authors: Emilie Sophie van der Valk Bouman; Heather Pump; David Borsook; Boris Severinsky; Robert Pl Wisse; Hajirah N Saeed; Eric A Moulton Journal: BMJ Open Ophthalmol Date: 2021-11-29