Accelerated Epi-on Versus Standard Epi-off Corneal CXL for Progressive Keratoconus in Pediatric Patients

Sunday, April 19, 2015: 9:05 AM
Room 5B (San Diego Convention Center)
Maria A. Henriquez, MD
Luis Izquierdo Jr, MD
Ana M. Rodriguez, MD

To evaluate and compare the effectiveness and safety of accelerate transepithelial (epi-on) corneal collagen crosslinking (CXL) compared to standard CXL (epi-off) in children with progressive keratoconus.

Prospective, comparative, study included 56 patients younger than 18 years old with progressive keratoconus between November 2013 to December 2014 . Accelerate transepithelial CXL (epi-on) was performed in 34 eyes using 30 minutes of impregnation, 5 minutes of irradiation (18mW), using TE-riboflavin and CCL-VARIO (Peschke Ltd). Standard CXL (epi-on) was performed in 22 eyes using 30 minutes of impregnation, 30 minutes of irradiation (3 mW/cm2), isotonic riboflavin 0.1%/dextran 20% solution and CCL-VARIO (Peschke Ltd). Scheimpflug imaging parameters where evaluated at pre and postoperatively at 1, 6 and 12 months.

Mean maximum keratometry change from 49.52 um to 48.90 um (p = 0.009) in the standard epi-off group and from 49.54 um to 49.33 um in the epi-on group (p = 0.034) at 6 months. Mean uncorrected visual acuity (UCVA) change from 0.62 um to 0.60 (p = 0.06) in the epi-on group and from 0.60  to 0.45 LogMAR in the epi-off group (p = 0.03) at 6 months. There was not statistical significant in terms of  keratometry and posterior elevation values between groups (P>.05) at 6 months postoperatively. There was not complications reported in this group of patients. Results at 12 months will be presented later.

Both accelerate crosslinking epi-on and standard epi-off procedures are safe and efficacy to stop the progression of the keratoconus at 6 months postoperatively. Longer follow up is necessary to confirm these results.