LETTER ARTICLE
Transepithelial Corneal Cross-linking with Supplemental Oxygen in Keratoconus Treatment - Corneal Stromal Demarcation Line and Safety
Jessica Qian Hui Choo1, Li Lim1, 2, *
Article Information
Identifiers and Pagination:
Year: 2022Volume: 16
E-location ID: e187436412207130
Publisher ID: e187436412207130
DOI: 10.2174/18743641-v16-e2207130
Article History:
Received Date: 27/12/2021Revision Received Date: 28/2/2022
Acceptance Date: 31/3/2022
Electronic publication date: 30/08/2022
Collection year: 2022
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.
Abstract
Purpose:
To evaluate the corneal stromal demarcation line and safety of transepithelial corneal cross-linking (CXL) with supplemental oxygen in progressive keratoconus treatment.
Methods:
This is a retrospective review of 25 patients with progressive keratoconus who underwent epithelial-on CXL with supplemental oxygen from December 2019 to February 2022. Outcomes measured include corneal stromal demarcation line depth, volume of cornea treated, endothelial cell count, best-corrected visual acuity, keratometric parameters and post-treatment adverse events.
Results:
25 eyes of 25 patients were included and mean age was 28.3 years. Mean follow-up period was 11.5 ± 1.39 months. Pre-operatively, mean ± standard deviation (SD) of K1, K2, Kmax and minimal corneal thickness were 45.9D ± 3.79D, 50.2D ± 4.83D, 57.5D ± 6.98D and 482.3um ± 36.8um respectively. There is no significant difference between pre and post-treatment corneal topographic parameters. There was improvement in BCVA post-treatment. The mean post-treatment corneal stromal demarcation line depth was 367.3 ± 89.8um. The volume of treated cornea including the central corneal epithelial thickness was 73.3 ± 4.39%. There was no reduction in endothelial cell count (ECC) post-procedure (pre-treatment mean ECC±SD: 2695.4 ± 224.5 cells/mm2, post-treatment ECC 2730.1 ± 252.0 cells/mm2, p-value = 0.33). Post-treatment corneal haze was mild and seen in 8 patients postoperatively. One patient developed a non-visual axis involving stromal infiltrate that resolved with topical broad-spectrum anti-microbials.
Conclusion:
Trans-epithelial CXL with supplemental oxygen for keratoconus treatment achieved comparable corneal stromal demarcation line depth comparable to that of conventional epithelial-off corneal cross-linking and had a similar safety profile.
