Outcomes of customized topographic guided epithelial debridement for corneal collagen cross-linking

Int Ophthalmol. 2022 Apr;42(4):1273-1280. doi: 10.1007/s10792-021-02114-3. Epub 2021 Nov 2.

Abstract

Purpose: To evaluate the outcomes of corneal collagen cross-linking performed with customized epithelial debridement technique in progressive keratoconic corneas.

Materials and methods: Forty eyes of 40 patients were included in the study. We performed an ophthalmologic examination and recorded the uncorrected visual acuity, best corrected visual acuity (BCVA), central corneal thickness at the thinnest point (t-CCT), flat meridian keratometry (K1), steep meridian keratometry (K2), endothelial cell density (ECC), hexagonal cells (HEX), and coefficient of variation of cell areas (CV) measured preoperatively and at the 1st, 3rd, 6th and 12th months postoperatively.

Results: The mean UCVA and BCVA were increased (p < 0.05). The mean flattest and steepest K readings were decreased (p < 0.05). The mean t-CCT decreased in the first months after treatment and increased after 6 months. The mean t-CCT was thicker at 12 months compared to pretreatment status (p < 0.05). The mean ECC and CV were not significantly different between follow-up intervals (p > 0.05). The mean HEX was statistically increased (p > 0.05).

Conclusions: Corneal collagen cross-linking performed with customized epithelial debridement technique is a successful alternative method for stopping the progression of keratoconus after 12 months of treatment.

Keywords: Corneal collagen cross-linking; Customized epithelial debridement; Keratoconus.

MeSH terms

  • Collagen / therapeutic use
  • Cornea / surgery
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use
  • Debridement
  • Humans
  • Keratoconus* / diagnosis
  • Keratoconus* / drug therapy
  • Keratoconus* / surgery
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Riboflavin / therapeutic use
  • Ultraviolet Rays

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin