June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Efficacy, Safety, Clinical and topographic outcomes of two corneal crosslinking for the treatment keratoconus in an referral center
Author Affiliations & Notes
  • Ricardo Blas Medina
    Instituto de Oftalmología Conde de Valenciana, Mexico city, Mexico
  • Arturo J Ramirez-Miranda
    Instituto de Oftalmología Conde de Valenciana, Mexico city, Mexico
  • Enrique O Graue-Hernandez
    Instituto de Oftalmología Conde de Valenciana, Mexico city, Mexico
  • Jesus Cabral
    Instituto de Oftalmología Conde de Valenciana, Mexico city, Mexico
  • Adrian Escudero-Rodriguez
    Instituto de Oftalmología Conde de Valenciana, Mexico city, Mexico
  • Footnotes
    Commercial Relationships   Ricardo Blas Medina, None; Arturo Ramirez-Miranda, None; Enrique Graue-Hernandez, None; Jesus Cabral, None; Adrian Escudero-Rodriguez, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3522. doi:
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      Ricardo Blas Medina, Arturo J Ramirez-Miranda, Enrique O Graue-Hernandez, Jesus Cabral, Adrian Escudero-Rodriguez; Efficacy, Safety, Clinical and topographic outcomes of two corneal crosslinking for the treatment keratoconus in an referral center. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3522.

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

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Abstract

Purpose : To determine the postoperative visual, keratometric and topographic outcomes of epi-on vs epi-off corneal crosslinking.

Methods : Prospective controlled longitudinal non-randomized study. We included 29 eyes of 15 patients with keratoconus diagnosis 73% males, mean age of 18.7 years-old. Twenty eyes underwent epi-off corneal crosslinking (≥400μm at the thinnest point) and 9 patients underwent epi-on corneal crosslinking (≤400μm at the thinnest point). Inclusion criteria were: progressive keratoconus diagnosed at least six months before the study (Progressive keratoconus was defined as an increase of ≥1D in manifest cylinder, an increase of ≥0.50 D in spherical equivalent, an increase of ≥1D in maximum keratometry and/or decreased in central corneal thickness of >5% in the previous six months).
Amsler-Krumeich stage of keratoconus, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometries, topographical data and pachymetry were considered to evaluate efficacy. Endothelial density (ED) Coefficient of Variation (CV), Hexagonality and IOP were considered to evaluate safety. Student T-test compared the preop measure vs the third month post-op visit.

Results : Preoperative mean CDVA was 0.34 ± 0.18 logMAR compared with 0.25 ±0.13 at 3 months postoperatively (p=0.03).
There was a significant decrease of mean K-values (p=0.05). No significant changes regarding pachymetry, ECD, VC and percentage of hexagonality were observed. No differences were observed between epi-on vs epi-off crosslinking.

Conclusions : Corneal crosslinking is an effective procedure for the treatment of incipient or moderate progressive keratoconus. CDVA, K-values, and pachymetry improved or stabilized at 3 months of treatment compared to preoperative values, despite the used technique. No side effects were detected in the corneal endothelium study at 3 months after treatment.

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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