Demarcation line depth after contact lens–assisted corneal crosslinking for progressive keratoconus: Comparison of dextran‐based and hydroxypropyl methylcellulose–based riboflavin solutions. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Malhotra, Chintan; Jain, Arun K.; Gupta, Amit; Ram, Jagat; Ramatchandirane, Balamurugan; Dhingra, Deepika; Sachdeva, Kulbhushan; Kumar, Amit
• Is Part Of: Journal of cataract and refractive surgery. Volume 43:Issue 10(2017)
• Publication Date: 2017-10
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2017.07.032
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose : To compare the demarcation line depth after contact lens–assisted corneal crosslinking (CXL) for progressive keratoconus using dextran‐based and hydroxypropyl methylcellulose (HPMC)‐based riboflavin solutions. Setting : Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Design : Retrospective case series. Methods : Patients with preoperative epithelium‐on (epi‐on) minimum corneal thickness between 350 μm and 450 μm having contact lens–assisted CXL for progressive keratoconus were crosslinked with isoosmolar 0.1% riboflavin in 20% dextran 500 or HPMC 1.1%. The primary outcome measure was the mean demarcation line depth measured 1 month postoperatively on anterior‐segment optical coherence tomography. The secondary outcome measure was change in endothelial cell density (ECD) 6 months from baseline. Results : The study comprised 21 patients (21 eyes, 9 in the HPMC group and 12 in the dextran group). The mean demarcation line depth was deeper in the HPMC group (308.22 μm ± 84.19 [SD]) than in the dextran group (235.33 ± 64.87 μm) ( P < .04). This difference remained significant ( P = .02) even after controlling for the preoperative lesser epi‐on minimum corneal thickness in the HPMC group (385.56 ±13.81 μm) versus the dextran group (413.08 ± 29.58 μm) ( P < .02). The ECD 6 months after contact lens–assisted CXL was comparable to the baseline levels in both groups ( P = .19 and P = .09, respectively). Conclusion : During contact lens–assisted CXL, HPMC‐based riboflavin seemed to be associated with a deeper demarcation line than dextran‐based riboflavin, although both solutions were safe for the endothelium at 6 months.