1. Thermographic analysis of the corneal surface in epi-on and epi-off corneal crosslinking for keratoconus.
- Author
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Fredriksson A, Elving S, Saric A, Winther N, Viberg A, and Behndig A
- Subjects
- Humans, Male, Female, Adult, Young Adult, Cornea diagnostic imaging, Corneal Stroma metabolism, Corneal Stroma drug effects, Corneal Topography methods, Body Temperature physiology, Keratoconus drug therapy, Keratoconus diagnosis, Keratoconus physiopathology, Keratoconus metabolism, Cross-Linking Reagents therapeutic use, Riboflavin therapeutic use, Photosensitizing Agents therapeutic use, Ultraviolet Rays, Photochemotherapy methods, Thermography methods, Collagen metabolism
- Abstract
Purpose: To analyse the temperature of the corneal surface in keratoconus during corneal customized crosslinking (CXL) with a preserved epithelium (epi-on) under oxygen flow, and epi-off CXL in room air, and to assess the effect of pre-heating the oxygen., Methods: This masked, intra-individual comparing randomized study included 14 participants with bilateral progressive keratoconus treated with bilateral CXL: one eye with epi-on CXL under a flow of 2.5 L/min oxygen; the fellow eye with epi-off CXL in room air. In a second setting involving 12 healthy participants, room-tempered oxygen was flushed over one eye and oxygen pre-heated to 37°C over the fellow eye. The corneal surface temperature was assessed with infrared photography., Results: A reduction in corneal surface temperature was seen from the pre-treatment application of topical riboflavin in the epi-off group (-1.1 ± 1.0°C, p < 0.001). The temperature increased during the first half of the CXL treatment in both groups (+0.7 ± 1.2°C, p = 0.041 for epi-on; +0.7 ± 0.9°C, p = 0.023 for epi-off CXL, respectively). In epi-on CXL an overall temperature increase was seen during the treatment (+0.8 ± 1.2°C, p = 0.016). In the second setting, pre-heating the oxygen rendered a surface temperature increase of +1.8 ± 0.2°C (p < 0.001)., Conclusion: In epi-off CXL, the application of topical room-tempered riboflavin decreases the corneal surface temperature, likely due to increased evaporation. A slight temperature increase is seen during CXL with both epi-on and epi-off CXL, albeit far below the corneal safety limit. The corneal temperature can, however, be increased by applying pre-heated oxygen, a possible approach to modify or augment the treatment effect in CXL., (© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
- Published
- 2024
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