Epithelium-Off Corneal Collagen Cross-linking Versus Transepithelial Cross-linking for Pediatric Keratoconus
- 1 May 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Cornea
- Vol. 32 (5), 597-601
- https://doi.org/10.1097/ico.0b013e31826cf32d
Abstract
PURPOSE:\ud To compare efficiency and safety of epithelium-off corneal cross-linking (CXL) and transepithelial cross-linking (TE-CXL) in pediatric patients with progressive keratoconus.\ud METHODS:\ud Uncorrected and corrected visual acuity, corneal topography and pachymetry (Pentacam; Oculus Pentacam), and in vivo confocal microscopy (HRT II, Rostock Cornea Module, Heidelberg Engineering, Heidelberg, Germany) were evaluated at baseline and at 3, 6, and 12 months.\ud RESULTS:\ud In the epithelium-off CXL group (19 patients, 23 eyes; mean age, 14.75 ± 2.1 years), a significant improvement at month 12 was present for Kmax [-1.11 diopters (D), P = 0.01], Kmin (-3.2 D, P = 0.001), mean K (-1.47 D, P = 0.01), surface asymmetry index (-0.64 D, P = 0.001), inferior-superior symmetry index (-0.54 D, P = 0.01), index of height asymmetry (-2.97, P = 0.03), and anterior elevation at the thinnest location (-2.82 D, P = 0.01) and at the apex (-2.27 D, P = 0.01). Postoperative corneal edema lasted 3 months in 16 eyes (69.5%) and more than 6 months in 2 eyes (8.7%). In the TE-CXL group (10 patients, 14 eyes; mean age, 15 ± 4.2 years), a significant improvement at month 12 was present for Kmax (-1.14 D, P = 0.02), Kmin (-2.04 D, P = 0.01), mean K (-1.63 D, P = 0.01), surface asymmetry index (-0.86 D, P = 0.001), inferior-superior symmetry index (-0.55 D, P = 0.001), index of height asymmetry (-2.95, P = 0.01), and anterior elevation at the thinnest location (-2.96 D, P = 0.01) and at the apex (-2.19 D, P = 0.01). No postoperative corneal edema after TE-CXL was observed. Changes at month 12 from baseline were not significantly different between the 2 groups (P > 0.05). TE-CXE was significantly less painful than epithelium-off CXL.\ud CONCLUSIONS:\ud In pediatric patients with progressive keratoconus, TE-CXL was less painful, provided similar effectiveness and fewer complications than epithelium-off CXL at 12-month follow-upKeywords
This publication has 27 references indexed in Scilit:
- Riboflavin-UVA-Induced Corneal Collagen Cross-linking in Pediatric PatientsCornea, 2012
- The Effect of Standard and Transepithelial Ultraviolet Collagen Cross-Linking on Human Corneal Nerves: An Ex Vivo StudyAmerican Journal of Ophthalmology, 2012
- Complications of Corneal Collagen Cross-LinkingJournal of Ophthalmology, 2011
- Age-Related Long-Term Functional Results after Riboflavin UV A Corneal Cross-LinkingJournal of Ophthalmology, 2011
- Long-term Results of Riboflavin Ultraviolet A Corneal Collagen Cross-linking for Keratoconus in Italy: The Siena Eye Cross StudyAmerican Journal of Ophthalmology, 2010
- Complication and failure rates after corneal crosslinkingJournal of Cataract & Refractive Surgery, 2009
- Corneal Healing After Riboflavin Ultraviolet-A Collagen Cross-Linking Determined by Confocal Laser Scanning Microscopy In Vivo: Early and Late ModificationsAmerican Journal of Ophthalmology, 2008
- Parasurgical therapy for keratoconus by riboflavin–ultraviolet type A rays induced cross-linking of corneal collagenJournal of Cataract & Refractive Surgery, 2006
- Risk Factors for Progression to Penetrating Keratoplasty in Patients With KeratoconusAmerican Journal of Ophthalmology, 2005
- Increased resistance of crosslinked cornea against enzymatic digestionCurrent Eye Research, 2004