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.