July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Morphological corneal changes up to one year after crosslinking surgery with and without intracorneal ring segment insertion
Author Affiliations & Notes
  • Lacey Haines
    School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
  • Olivera Kralj
    Dept. of Physics and Astronomy, University of Waterloo School of Optometry and Vision Science, Waterloo, Ontario, Canada
  • Sebastian Marschall
    Oculus, Wetzlar, Germany
  • Ahmed Gawish
    Systems Design Engineering Dept., University of Waterloo School of Optometry and Vision Science, Waterloo, Ontario, Canada
  • Paul Fieguth
    Systems Design Engineering Dept., University of Waterloo School of Optometry and Vision Science, Waterloo, Ontario, Canada
  • Neera Singal
    Dept. of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Hall Chew
    Dept. of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • David Rootman
    Dept. of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Allan Slomovic
    Dept. of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Wendy Hatch
    Dept. of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Kostadinka K Bizheva
    Dept. of Physics and Astronomy, University of Waterloo School of Optometry and Vision Science, Waterloo, Ontario, Canada
  • Luigina Sorbara
    School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
  • Footnotes
    Commercial Relationships   Lacey Haines, None; Olivera Kralj, None; Sebastian Marschall, Oculus (E); Ahmed Gawish, None; Paul Fieguth, None; Neera Singal, None; Hall Chew, None; David Rootman, None; Allan Slomovic, None; Wendy Hatch, None; Kostadinka Bizheva, None; Luigina Sorbara, None
  • Footnotes
    Support  NSERC-312037; CIHR-CHRP 446387; CIHR-CPG 127791
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6323. doi:
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    • Get Citation

      Lacey Haines, Olivera Kralj, Sebastian Marschall, Ahmed Gawish, Paul Fieguth, Neera Singal, Hall Chew, David Rootman, Allan Slomovic, Wendy Hatch, Kostadinka K Bizheva, Luigina Sorbara; Morphological corneal changes up to one year after crosslinking surgery with and without intracorneal ring segment insertion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6323.

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

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Abstract

Purpose : Knowledge of morphological changes induced by crosslinking (CXL) and CXL plus intrastromal ring segment (CXL+ICRS) surgeries may help guide treatment decisions. This observational study investigates alterations in corneal shape during and after CXL treatments and identifies predictive factors.

Methods : 64 eyes with keratoconus from 39 subjects were imaged with a Scheimpflug topographer prior to receiving CXL surgery and one year after. From this sample, 11 eyes that received CXL surgery and 8 eyes that received CXL+ICRS surgery were imaged with a research grade swept-source optical coherence tomographer (SS-OCT). The thicknesses of the cornea (TCT) and epithelial layer (ET) were acquired from SS-OCT images using custom processing software. The minimum corneal thickness (MCT) during surgery was measured using an ultrasound (US) pachymeter.

Results : For CXL only, there was no significant difference between MCT from preoperative SS-OCT estimates and intraoperative US measurements (p>0.05). For CXL+ICRS, the preoperative SS-OCT MCT was significantly thinner than the US MCT (p=0.03). The mean ET did not change significantly one year after CXL only (p=0.82), but demonstrated a significant decrease of five microns for CXL+ICRS (p=0.01). For CXL only, baseline ET was predictive for changes in ET (R2=0.407,p= 0.029) and TCT (R2=0.364,p= 0.048), and age was significantly correlated with TCT changes at one year (R2=0.388,p= 0.048). For CXL+ICRS, age was predictive for changes in TCT at one year (R2=0.74,p= 0.006). There were no significant differences in the locations of the points of highest elevation, thinnest pachymetry or maximum curvature (p>0.05 for all) one year after CXL, however, individual data shows some eyes may experience clinically significant shifts.

Conclusions : Preoperative MCT estimates do not correlate well with intra-operative pachymetry measurements. Changes in ET and TCT are correlated with baseline ET and age. The locations of topographical features do not show large changes one year after surgery, although some individual corneas may demonstrate clinically significant modifications.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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