Pachymetric Assessment After EpiSmart® Epithelium-on Cross-Linking for Keratoconus and Post-Surgical Ectasia

Neel S Vaidya; Arvin Daneshmand; Randy J Epstein; Parag A Majmudar; Michael W Belin; Edward C Parsons; Roy S Rubinfeld

doi:10.2147/OPTH.S359710

Pachymetric Assessment After EpiSmart^® Epithelium-on Cross-Linking for Keratoconus and Post-Surgical Ectasia

Clin Ophthalmol. 2022 Jun 8:16:1829-1835. doi: 10.2147/OPTH.S359710. eCollection 2022.

Authors

Neel S Vaidya^{1

2}, Arvin Daneshmand³, Randy J Epstein^{1

2}, Parag A Majmudar^{1

2}, Michael W Belin^{4

5}, Edward C Parsons⁵, Roy S Rubinfeld^{5

6

7}

Affiliations

¹ Chicago Cornea Consultants, Highland Park, IL, USA.
² Department of Ophthalmology, Rush University Medical Center, Chicago, IL, USA.
³ Georgetown University Medical School, Washington, DC, USA.
⁴ Department of Ophthalmology, University of Arizona, Tucson, AZ, USA.
⁵ CXL Ophthalmics, LLC, Encinitas, CA, USA.
⁶ Department of Ophthalmology, Georgetown University Medical School/Washington Hospital Cente, Washington, DC, USA.
⁷ Re:Vision Private Practice, Rockville, MD, USA.

Abstract

Purpose: To assess the change in corneal pachymetry after a novel epithelium-on (EpiSmart^®) corneal crosslinking procedure (CXL).

Methods: Eyes treated as part of the open-label, non-controlled arm of the study "Collagen Crosslinking with Ultraviolet-A in Asymmetric Corneas" (NCT01097447) were examined at baseline, 3-, 6- and 12-months post-CXL. Thinnest pachymetry readings based on Pentacam (OCULUS GmbH, Wetzlar, Germany) were recorded.

Results: A total of 101 eyes met the study inclusion criteria. Thinnest pachymetric readings at baseline averaged 451 ± 50 microns. The mean (± SD) minimum thickness was 450 ± 46 microns at 3 months, 452 ± 47 microns at 6 months, and 451 ± 48 microns at 12 months post-CXL. The changes from baseline (mean ± SE) at 3, 6, and 12 months post-CXL were -1.2 ± 1.5 microns, 0.5 ± 1.6 microns, and 0.4 ± 1.6 microns, respectively. Student's t-tests showed no statistically significant change in pachymetry from baseline for any exam period.

Conclusion: This study demonstrated that, after EpiSmart^® epithelium-on CXL, there was no substantial corneal thinning observable on Scheimpflug tomography out to 12 months.

Keywords: corneal thinning; cross-linking; epithelium-on; keratoconus; pachymetry; post-surgical ectasia.