Epithelium-on Cornea Collagen CXL for Keratoconus: Increasing Patient Comfort Without Sacrificing Efficacy
Purpose
Epithelium-on cornea collagen cross linking (CXL) is a more comfortable procedure than epithelium-off, but is still quite uncomfortable. The study was done to investigate a way to make the procedure more comfortable for the patients without sacrificing efficacy.
Methods
A 10mm Chayet LASIK sponge was used to protect the conjunctiva. Peripheral BSS wash of the conjunctiva was added to further eliminate chemical conjunctival toxicity during the procedure.
Pain/discomfort questionnaire was used after epithelium-on CXL with the Chayet sponge to assess patient pain scores.
Prospective case series.
Patient ages ranged from 10-40.
Results
Pain was dramatically reduced to a score of 0 (scale 1-10) in all patients except one of the bilateral cases, the first patient in the study.
Conclusion
Epithelium-on cornea collagen cross linking is a more comfortable procedure than epithelium-off, but is still quite uncomfortable. Using a Chayet sponge and peripheral conjunctival BSS wash can drastically reduce pain scales to 0 in almost all epithelium on Crosslinking cases, and potentially can reduce pain in epithelium off procedures as well.