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J. M. Ackert, K. L. Fry, S. Greenstein, P. S. Hersh; Effects of Collagen Cross Linking on Function of Corneal Endothelium. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2826.
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To investigate the effect of collagen crosslinking on corneal endothelium using endothelial cell count (ECC) as a measure of corneal endothelial function.
34 patients (40 eyes) underwent CXL for keratoconus (KC) or ectasia (23 and 17 eyes respectively). CXL was performed using the UVX system (Peschke Meditrade GmbH) using the technique of Seiler and colleagues. Endothelial cell count was obtained using specular microscopy (Konan Medical) prior to treatmentand at 12 months. To standardize measurement, all identifiable cells in the image were counted. Only those images with good quality readings, as defined by ability to identify at least 50 cells per field, were analyzed. Data from 30 patients (36 eyes) met our criterion for analysis. Of these 36 eyes, 20 had KC and 15 had corneal ectasia. ECC was compared at baseline and at one year using student’s t-test for all patients, and a sub-group analysis was done for both KC and ectasia patients.
For the entire cohort mean preoperative ECC was 2288.4 (SD 298.1497) and postoperatively mean ECC was 2213.3 (SD 272.5917). Similarly, ECC remained statistically unchanged at one year for both patients with corneal ectasia subgroup and KC subgroups analyzed separately (p value for cohort =0.1, p = 0.18 for KC, p=0.35 for ectasia ECC counts were also compared via between treated patients and control patients (patients with either KC or ectasia randomized to sham treatment).
Collagen crosslinking does not appear to effect the integrity of the corneal endothelium and thus should not significantly impair endothelial function.
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