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Efficacy of transepithelial corneal collagen crosslinking for keratoconus: 12-month follow-up

Authors Heikal MA, Soliman TT, Fayed A, Hamed AM

Received 30 November 2016

Accepted for publication 28 January 2017

Published 21 April 2017 Volume 2017:11 Pages 767—771

DOI https://doi.org/10.2147/OPTH.S129037

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Mohamed A Heikal, Tarek Tawfik Soliman, Ayser Fayed, Abdelmonem M Hamed

Department of Ophthalmology, Benha University, Benha, Egypt

Purpose: To evaluate the efficacy of transepithelial corneal collagen crosslinking (TE-CXL) in patients with progressive keratoconus.
Patients and methods: This is a prospective interventional consecutive study carried out on 30 eyes of 18 patients with progressive keratoconus who underwent TE-CLX using both ParaCel™ (riboflavin 0.25%, hydroxy propyl methyl cellulose, NaCl, ethylenediaminetetraacetic acid [EDTA], Tris, and benzalkonium chloride) and vibeX-Xtra (riboflavin 0.22%, phosphate-buffered saline solution). The procedure was carried out at Ebsar Eye Center in Egypt in the period from 2012 to 2014. The follow-up visits were scheduled on days 1, 3, 6, and 12 months after treatment.
Results: There were statistically significant improvements (P<0.001) in the mean best-corrected visual acuity (0.54±0.22 preoperatively vs 0.61±0.19 at 12 months postoperatively), the mean manifest refraction spherical equivalent (MRSE; -6.16±3.90 diopters [D] preoperatively and -5.91±3.72 D at 12 months postoperatively), and the mean preoperative corneal astigmatism (-3.39±2.11 D preoperatively and -2.46±2.60 D at 12 months postoperatively).
Conclusion: TE-CXL could halt the progression of keratoconus in adult patients. TE-CXL resulted in a statistically significant improvement in best-corrected visual acuity, manifest refraction, refractive and corneal astigmatism and K values in keratoconus patients at the 12-month follow-up. Larger sample sizes and longer follow-ups are required in order to make meaningful conclusions.

Keywords:
corneal astigmatism, refractive astigmatism, transepithelial crosslinking, progressive keratoconus

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