June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Outcomes of spatial modulation of UVA beam intensity to minimize delivered UVA energy in corneal crosslinking
Author Affiliations & Notes
  • Abhijit Sinha Roy
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Rohit Shetty
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Natasha Pahuja
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Roshan T
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Rashmi Deshmukh
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Mathew Francis
    Ophthalmology, Narayana Nethralaya, Bangalore, India
  • Footnotes
    Commercial Relationships   Abhijit Sinha Roy, None; Rohit Shetty, None; Natasha Pahuja, None; Roshan T, None; Rashmi Deshmukh, None; Mathew Francis, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4345. doi:
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    • Get Citation

      Abhijit Sinha Roy, Rohit Shetty, Natasha Pahuja, Roshan T, Rashmi Deshmukh, Mathew Francis; Outcomes of spatial modulation of UVA beam intensity to minimize delivered UVA energy in corneal crosslinking. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4345.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the performance of different customized corneal crosslinking (CXL) methods

Methods : Four different customized CXL methods were evaluated in keratoconic eyes. These methods were as follows: (a) uniform intensity UVA beam (9 mW/cm2) for 10 minutes; (b) sector based UVA irradiation (Figure 1B); (c) concentric rings of UVA beam intensity centered at the steepest curvature of anterior axial map (Figure 1A); (d) same as (c) but centered at the steepest curvature of anterior tangential map. Peak UVA energy density in (b) and (c) (as well as (d)) didn’t exceed 15.0 and 10.8 J/cm2, respectively. 0.1% solution riboflavin solution was applied after epithelium removal. Corneal tomography and visual acuity was assessed before and 6 months after CXL.

Results : The number of eyes in each treatment group was 12 to 14 eyes. Only one eye per patients was included in the analyses. Average and peak energy density was lowest in method (d) [2.424±0.068 J/cm2] and highest in (b) [8.316±0.392 J/cm2] (p<0.001). Treated area was lowest in method (d) [32.699±3.554 mm2] and highest in method (a) [63.63±0.00 mm2] (p<0.001). Maximum curvature decreased by a mean of 1.71, 1.51, 0.44 and 1.31D in method (a), (b), (c) and (d), respectively. Decrease in Pentacam overall deviation index (BAD-D) and cone location magnitude index was similar between all the methods (p>0.05). Decrease in curvature was similar among methods (a), (b) and (c) (p<0.05). Therefore, all curvature indices were normalized with the average UVA energy density and re-analyzed. Method (d) had the greatest decrease in curvature per unit energy dose to the cornea (p<0.05). Improvement in UDVA (0.081±0.056) and CDVA (0.041±0.026) per unit energy density was greatest in method (d) but required greater sample size for significance (p>0.05).

Conclusions : Method (d) appeared to provide maximum flattening and improvement in visual acuity. Further studies with larger sample size are needed to validate the findings of this pilot study.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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