Demarcation Line Depth in Epithelium-Off Corneal Cross-Linking Performed at the Slit Lamp

Farhad Hafezi; Nan-Ji Lu; Jad F Assaf; Nikki L Hafezi; Carina Koppen; Riccardo Vinciguerra; Paolo Vinciguerra; Mark Hillen; Shady T Awwad

doi:10.3390/jcm11195873

Demarcation Line Depth in Epithelium-Off Corneal Cross-Linking Performed at the Slit Lamp

J Clin Med. 2022 Oct 4;11(19):5873. doi: 10.3390/jcm11195873.

Authors

Farhad Hafezi^{1

2

3

4

5}, Nan-Ji Lu^{2

5

6}, Jad F Assaf⁷, Nikki L Hafezi^{1

2

6}, Carina Koppen⁶, Riccardo Vinciguerra^{8

9}, Paolo Vinciguerra^{10

11}, Mark Hillen², Shady T Awwad⁷

Affiliations

¹ Laboratory for Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, 8006 Zurich, Switzerland.
² ELZA Institute, 8953 Dietikon, Switzerland.
³ USC Roski Eye Institute, University of Southern California, Los Angeles, CA 90007, USA.
⁴ Department of Ophthalmology, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland.
⁵ School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325015, China.
⁶ Department of Ophthalmology, University of Antwerp, 2610 Wilrijk, Belgium.
⁷ Department of Ophthalmology, American University of Beirut Medical Center, Beirut 1107, Lebanon.
⁸ Department of Ophthalmology, Humanitas San Pio X Hospital, 20100 Milan, Italy.
⁹ The School of Engineering, University of Liverpool, Liverpool L69 3BX, UK.
¹⁰ Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Milan, Italy.
¹¹ Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, 20089 Milan, Italy.

Abstract

We aimed to evaluate the depth of the demarcation line following accelerated epithelium-off corneal cross-linking (A-CXL) performed at the slit lamp with the patient sitting in an upright position. Twenty-three eyes from twenty patients, undergoing epi-off A-CXL (9 mW/cm² for 10 min) using a CXL device at the slit lamp in the upright position. Demarcation line depth was assessed at 1 month after the procedure using anterior segment optical coherence tomography (AS-OCT) and specialized software. Surgery was uneventful in all cases. The average postoperative demarcation line depth achieved was 189.4 µm (standard deviation: 58.67 µm). The demarcation line depth achieved with patients sitting upright, receiving CXL at the slit lamp, is similar to published data on CXL performed in the supine position, suggesting that demarcation line depth is not dependent on patient orientation during CXL.

Keywords: CXL; cornea; corneal cross-linking; ectasia; keratoconus; slit lamp.

Abstract

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