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Comparison of transepithelial corneal crosslinking with epithelium-off crosslinking (epithelium-off CXL) in adult Pakistani population with progressive keratoconus
- Source :
- Taiwan Journal of Ophthalmology, Taiwan Journal of Ophthalmology, Vol 7, Iss 4, Pp 185-190 (2017)
- Publication Year :
- 2017
- Publisher :
- Medknow Publications & Media Pvt Ltd, 2017.
-
Abstract
- PURPOSE: The purpose of this study is to compare the safety and efficacy of transepithelial corneal crosslinking (CXL) with epithelium-off crosslinking (epithelium-off CXL) in the treatment of progressive keratoconus in adult Pakistani population. MATERIALS AND METHODS: Sixty-four eyes of 64 consecutive patients of progressive keratoconus were included in this quasi-experimental study. Thirty-two eyes received transepithelial CXL with Peschke TE (0.25% riboflavin (Vitamin B2), 1.2% hydroxypropyl methylcellulose (HPMC), 0.01% benzalkonium chloride) and 32 eyes received epithelium-off CXL with Peschke M (0.1% riboflavin (Vitamin B2) 0.1%, HPMC 1.1%.) The cornea was then exposed to ultraviolet A light at an irradiance of 3 mW/cm2 for 30 min. The primary outcome measure, clinical stabilization of keratoconus was defined as an increase of no more than 1D in Kmax at 1 year. Other parameters evaluated at baseline and 3, 6, 12, and 18 months postoperatively were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), astigmatism (Ast), simulated keratometry, steep keratmetry (steep K), and corneal thickness at thinnest point (pachy thin). RESULTS: Both epithelium-off CXL and transepithelial CXL groups showed a significant reduction in Kmax, steep K, simulated K, corneal pachymetry at all test points (P < 0.05) with significantly greater reductions achieved in epithelium-off CXL group at 18 months follow-up. The mean UDVA, CDVA, SE, Ast significantly improved in both groups (P < 0.05). The mean postoperative UDVA and CDVA between the groups were not significant at 12 months (P = 0.650, 0.018, respectively). Clinical stabilization was achieved in 94% of eyes in epithelium-off CXL and 75% of eyes in transepithelial CXL. In epithelium-off CXL, three eyes exhibited stromal haze resolved by corticosteroid treatment. No complication was documented in transepithelial CXL group. CONCLUSION: Transepithelial CXL is not recommended to be replaced completely by standard epithelium-off CXL due to continued ectatic progression in 25% of cases. However, thin corneas, unfit for standard epithelium-off CXL, can benefit from transepithelial CXL.
- Subjects :
- medicine.medical_specialty
Keratoconus
genetic structures
Astigmatism
law.invention
03 medical and health sciences
Benzalkonium chloride
0302 clinical medicine
lcsh:Ophthalmology
law
Ophthalmology
Cornea
medicine
Corneal pachymetry
Adult Pakistani population
Keratometer
medicine.diagnostic_test
business.industry
transepithelial corneal crosslinking
Pakistani population
progressive keratoconus
epithelium-off corneal crosslinking
medicine.disease
Epithelium
eye diseases
medicine.anatomical_structure
lcsh:RE1-994
030221 ophthalmology & optometry
Optometry
Original Article
sense organs
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 22115072 and 22115056
- Volume :
- 7
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Taiwan Journal of Ophthalmology
- Accession number :
- edsair.doi.dedup.....25615f7c5bebe76696ba5be7b4d75be4