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Leopoldo Spadea, Giuseppina Marrazzo; Improvement of symptoms post-epi-off CXL by an ophthalmic solution containing 0.05% cyanocobalamine, 0.5% taurine and 0.5% long-chained hyaluronic acid. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3012.
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© ARVO (1962-2015); The Authors (2016-present)
Corneal collagen crosslinking (CXL) has gained worldwide popularity over the past several years as an effective means of strengthening the cornea and thereby reducing, if not eliminating, the progression of ectatic disorders of the cornea such as keratoconus. Unfortunately, there are several major obstacles, at least from the patient’s perspective, when epithelial removal is performed during the traditional epithelium off (epi-off) CXL procedure. Patients experience considerable pain for some days after this procedure.<br /> We evaluated whether a daily topical administration of an Ophthalmic solution containing sodium hyaluronate 0.5%, vitamin B12 0.05% and taurine 0.5% (Ialuvit®, Alfa Intes, Italy) can counteract the symptoms of the patients underwent to epi-off CXL.
Records from 20 eyes of 20 patients diagnosed as having progressive keratoconus who underwent epi-off CXL were selected. In addition to routine post-operative protocol the treatment consisted in a four times daily topical administration of: Ialuvit® (10 patients-Goup A); and balanced saline solution as control (10 patients-Group B). Corneal sensitivity has been evaluated using the Cochet-Bonnet aesthesiometer and frequency and extent of symptoms (foreign body sensation, stinging, burning, discomfort at blinking) have been registered using a VARS before and 7, 30 and 90 days after surgery.
Our results confirmed that the Epi-off CXL procedure has an impact on corneal sensitivity. However after three months treatment there was a complete recovery in the Ialuvit® treated group. Foreign body sensation, burning, stinging and discomfort at blinking were significantly different in Group A patients when compared to the control group, both as frequency and extent of symptom perception (p<0.005) at 7 days after epi-off CXL. Finally, there was a strong correlation between symptoms and corneal sensitivity values, at each considered point.
The present data show that adding to post-surgery therapy an ophthalmic solution whose ingredients (especially cyanocobalamine and taurine) have an impact on nerves could improve cornea health thus reducing patient dissatisfaction, when the adjunctive therapy is extended from 1 to 3 months after surgery.
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