Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation. (30th July 2012)

• Record Type: Journal Article
• Authors: Stojanovic, Aleksandar; Chen, Xiangjun; Jin, Nan; Zhang, Ting; Stojanovic, Filip; Raeder, Sten; Utheim, Tor Paaske
• Other Names: Lee Andrew G. Academic Editor.
• Is Part Of: Journal of ophthalmology. Volume 2012(2012)
• Publication Date: 2012-07-30
• Subjects: Ophthalmology -- Periodicals; Eye Diseases; Ophthalmology; Ophthalmology; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 617.7
• DOI: 10.1155/2012/498435
• Languages: English
• ISSNs: 2090-004X

Abstract

Abstract : Purpose . To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation. Methods . This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative. Results . At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max- K at the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrations S 3, 5, 7 (P = 0.04 ). Postoperative pain without other complications was recorded. Conclusion . Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus.