Transepithelial versus Epithelium off Crosslinking for Treating Keratoconus among Jordanians



Khalid Al Zubi1, *, Yaser Albakar2, Rana Nasser2
1 Faculty of Medicine, Mutah University, Al-Karak, Jordan
2 Saraya Eye Centre, Amman, Jordan

Abstract

Background:

The progression of keratoconus is stabilized with the help of corneal collagen cross-linking (CXL) supported through photosynthesized riboflavin.

Objective:

This study aims to compare the effectiveness of the transepithelial procedure and epithelium off procedure of corneal collagen crosslinking among keratoconus patients in Jordan.

Method:

The study recruited 80 patients suffering from progressive keratoconus, from a tertiary care setting in Jordan. These participants were randomly divided into two groups; group 1 with 40 participants subjected to transepithelial (Corneal collagen cross-linking) CXL; and 40 participants in group 2 received conventional epithelium off CXL.

Results:

Improvement was observed in the mean contact lens, which corrected distance visual acuity (CDVA) from logMAR 0.332 ± 0.09 (group 1), 0.35 ± 0.09 (group 2) to 0.241 ± 0.07 (group 1), 0.21 ± 0.07 (group 2), respectively at the end of follow-up (12 months). The mean pachymetry improved from 429.81 ± 18.96 μm (group 1), 430.08 ± 17.05 μm (group 2) to 436.5 ± 15.49 μm (group 1), 436.44 ± 12.53 μm (group 2), respectively, after twelve months. Additionally, the mean Sim K astigmatism declined from 7.0 ± 2.0 (group 1), 6.73 ± 1.98 (group 2) to 5.97 ± 1.88 (group 1), 5.53 ± 0.08 (group 2) respectively at twelve months post-treatment. Majority of the patients in group 2 experienced more pain as compared to group 1 participants.

Conclusion:

The effectiveness of a cross-linking procedure related to keratometry readings and corneal thickness showed that conventional (epithelium off) CXL method is more effective than transepithelial CXL.

Keywords: Keratoconus, Collagen, Cornea, Crosslinking, Visual Acuity, Keratoplasty.


Abstract Information


Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOOPHTJ-2018-39

Article History:

Received Date: 7/11/2018
Revision Received Date: 24/12/2018
Acceptance Date: 18/1/2019
Electronic publication date: 07/02/2019
Collection year: 2019

© 2019 Al Zubi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Correspondence: Address correspondence to this author at the Faculty of Medicine, Mutah University, Al-Karak, Postal Address: P. O. Box 1342 Aljubaiha, Amman 11941, Jordan; Tel: 00962797950830; E-mail: dr_khalidzu@yahoo.com