Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study

Hany A Khairy, Hatem M Marey, Amin Faisal Ellakwa Ophthalmology Department, Menoufia University Hospitals, Menofia, Egypt Purpose: To evaluate the outcome of collagen cross-linking (CXL) without corneal epithelial debridement in patients treated for progressive keratoconus for whom the standard ep...

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Autores principales:	Khairy HA, Marey HM, Ellakwa AF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4c0e084295c347b985ebd66eed2b9781
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spelling	oai:doaj.org-article:4c0e084295c347b985ebd66eed2b97812021-12-02T00:24:56ZEpithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study1177-5483https://doaj.org/article/4c0e084295c347b985ebd66eed2b97812014-04-01T00:00:00Zhttp://www.dovepress.com/epithelium-on-corneal-cross-linking-treatment-of-progressive-keratocon-a16608https://doaj.org/toc/1177-5483 Hany A Khairy, Hatem M Marey, Amin Faisal Ellakwa Ophthalmology Department, Menoufia University Hospitals, Menofia, Egypt Purpose: To evaluate the outcome of collagen cross-linking (CXL) without corneal epithelial debridement in patients treated for progressive keratoconus for whom the standard epithelium-off treatment cannot be applied, as their central corneal thickness (CCT) is less than 400 µm. Patients and methods: This was a prospective, uncontrolled, interventional study involving 32 eyes of 30 patients with progressive keratoconus and CCT of less than 400 µm. All patients received CXL treatment with application of riboflavin and exposure to ultraviolet light A for 30 minutes without corneal epithelial debridement. Patients were followed up to 12 months postoperatively. The main outcomes were changes in maximum-K reading, manifest refractive spherical equivalent, CCT, and best-corrected visual acuity (logarithm of minimum angle of resolution). Patients were also asked to report any pain or discomfort during the procedure. Results: At the end of the 12-month follow-up, CCT showed no significant change: from 392±5.17 µm preoperatively to 390±4.45 µm (P=0.102). Maximum-K reading decreased significantly, from 49.19±2.30 D preoperatively to 46.96±6.03 D postoperatively (P<0.05). The mean manifest spherical equivalent showed no significant change: from 4.04±1.51 D preoperatively to 4.17±1.63 D postoperatively (P=0.110). Mean best-corrected visual acuity showed no significant change: from 0.29±0.12 preoperatively to 0.31±0.11 postoperatively (P=0.110). Conclusion: Epithelium-on CXL exhibits potential as a method for treating patients with progressive keratoconus and CCT of less than 400 µm, in which the standard epithelium-off CXL cannot be applied. Over 12 months of follow-up, the epithelium-on CXL was safe and effective, with results comparable to that achieved with the epithelium-off technique in thicker corneas, and reduced rates of operative and postoperative discomfort. Keywords: keratoconus, cross-linking, refractive surgery, epitheliumKhairy HAMarey HMEllakwa AFDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 819-823 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Khairy HA Marey HM Ellakwa AF Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
description	Hany A Khairy, Hatem M Marey, Amin Faisal Ellakwa Ophthalmology Department, Menoufia University Hospitals, Menofia, Egypt Purpose: To evaluate the outcome of collagen cross-linking (CXL) without corneal epithelial debridement in patients treated for progressive keratoconus for whom the standard epithelium-off treatment cannot be applied, as their central corneal thickness (CCT) is less than 400 µm. Patients and methods: This was a prospective, uncontrolled, interventional study involving 32 eyes of 30 patients with progressive keratoconus and CCT of less than 400 µm. All patients received CXL treatment with application of riboflavin and exposure to ultraviolet light A for 30 minutes without corneal epithelial debridement. Patients were followed up to 12 months postoperatively. The main outcomes were changes in maximum-K reading, manifest refractive spherical equivalent, CCT, and best-corrected visual acuity (logarithm of minimum angle of resolution). Patients were also asked to report any pain or discomfort during the procedure. Results: At the end of the 12-month follow-up, CCT showed no significant change: from 392±5.17 µm preoperatively to 390±4.45 µm (P=0.102). Maximum-K reading decreased significantly, from 49.19±2.30 D preoperatively to 46.96±6.03 D postoperatively (P<0.05). The mean manifest spherical equivalent showed no significant change: from 4.04±1.51 D preoperatively to 4.17±1.63 D postoperatively (P=0.110). Mean best-corrected visual acuity showed no significant change: from 0.29±0.12 preoperatively to 0.31±0.11 postoperatively (P=0.110). Conclusion: Epithelium-on CXL exhibits potential as a method for treating patients with progressive keratoconus and CCT of less than 400 µm, in which the standard epithelium-off CXL cannot be applied. Over 12 months of follow-up, the epithelium-on CXL was safe and effective, with results comparable to that achieved with the epithelium-off technique in thicker corneas, and reduced rates of operative and postoperative discomfort. Keywords: keratoconus, cross-linking, refractive surgery, epithelium
format	article
author	Khairy HA Marey HM Ellakwa AF
author_facet	Khairy HA Marey HM Ellakwa AF
author_sort	Khairy HA
title	Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
title_short	Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
title_full	Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
title_fullStr	Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
title_full_unstemmed	Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
title_sort	epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/4c0e084295c347b985ebd66eed2b9781
work_keys_str_mv	AT khairyha epitheliumoncornealcrosslinkingtreatmentofprogressivekeratoconusaprospectiveconsecutivestudy AT mareyhm epitheliumoncornealcrosslinkingtreatmentofprogressivekeratoconusaprospectiveconsecutivestudy AT ellakwaaf epitheliumoncornealcrosslinkingtreatmentofprogressivekeratoconusaprospectiveconsecutivestudy
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Epithelium-on corneal cross-linking treatment of progressive keratoconus: a prospective, consecutive study

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