Outcomes of corneal collagen crosslinking using a customized epithelial debridement technique in keratoconic eyes with thin corneas

Abstract

The purpose of the study was to evaluate the outcomes and possible complications of CXL performed with customized epithelial debridement technique to keratoconic corneas with the thinnest pachymetry values less than 400 µm. Nineteen eyes of 19 patients were included. The uncorrected (UCVA) and best corrected visual acuity (BCVA), flattest and steepest keratometric (K) readings, central corneal thickness at the thinnest point (t-CCT), endothelial cell density (ECD) were assessed before and 12 months after CXL. The mean UCVA was increased (p = 0.001), while the mean BCVA did not show any difference (p > 0.05). The mean flattest and steepest K readings were decreased (p = 0.001). No change was observed in the mean t-CCT (p > 0.05). The mean ECD was decreased (p = 0.001). The mean pre-CXL and post-CXL percentages of polymegathism and pleomorphism did not show any significant difference (p > 0.05). CXL performed with customized epithelial debridement technique is successful in halting the progression of keratoconus in corneas thinner than 400 µm after 12 months of treatment. However, significant endothelial cell loss can occur after this procedure.

Outcomes of iontophoretic corneal collagen crosslinking in keratoconic eyes with very thin corneas

“…The authors conclude that this method is capable of halting the progression of keratoconus with thin corneas. [ 21 ]…”

“…Our results on UDVA and CDVA are similar to those of other studies that recorded the stabilization or improvement of these parameters at the end of the follow-up period. [ 11 , 21 , 22 , 30 ]…”

“…The K max value statistically decreased significantly from the sixth postoperative month to the last part of the follow-up period; our results are consistent with other studies. [ 11 , 21 , 22 , 30 ]…”

“…Twelve months after surgery we observed a slight increase in CTTP (approximately 15 μ) that is statistically significant; no change in thickness was observed in other studies. [ 11 , 21 , 22 ]…”

Morphologische Hornhautveränderungen nach Crosslinking bei Keratokonus

“…Bei entsprechender Vorgeschichte wird ein perioperativer Virostatikaschutz empfohlen [44]. Der potenziell endotheltoxische Effekt des Crosslinkings wurde bereits 2003 experimentell nachgewiesen [36,163] und auch in einzelnen Fallberichten beschrieben [164][165][166][167][168]. Bei Beachtung der Limitationen (Hornhautdicke > 400 μm) bzw.…”