Efficacy and Safety of Contact Lens-Assisted Corneal Crosslinking in the Treatment of Keratoconus With Thin Corneas.

Citation:
Nour, M. M., M. - S. H. El-Agha, A. M. Sherif, and S. M. Shousha, "Efficacy and Safety of Contact Lens-Assisted Corneal Crosslinking in the Treatment of Keratoconus With Thin Corneas.", Eye & contact lens, vol. 47, issue 9, pp. 500-504, 2021.

Abstract:

OBJECTIVE: To evaluate the safety and efficacy of contact lens-assisted crosslinking (CA-CXL) in progressive keratoconus with thin corneas (350-400 µm).

METHODS: Forty eyes (30 patients) underwent epithelium-off CA-CXL with iso-osmolar riboflavin and ultraviolet-A irradiation for 30 min (fluence, 3 mW/cm2). A non-ultra-violet-absorbing soft contact lens (sCL) soaked in riboflavin was applied over the cornea during irradiation. Demarcation line (DL) depth was measured 1 month postoperatively. Endothelial cell count (ECC) was measured preoperatively and 3 months postoperatively. Distance uncorrected visual acuity (UDVA) and best spectacle-corrected visual acuity (BDVA), and maximum keratometric values (K max) were evaluated preoperatively and 9 months postoperatively.

RESULTS: The sCL added a mean thickness of 100.05±1.23 µm. The mean ECC was 2,982±165 cell/mm2 preoperatively and 2,955±125 cell/mm2 postoperatively (endothelial cell loss, 0.9%, P=0.21). The mean DL depth was 204.8±20.2 µm. There was significant improvement in UDVA (P<0.001) and BDVA (P=0.011) with a stable K max (P=0.06).

CONCLUSION: Contact lens-assisted crosslinking was safe and effective, with endothelial loss less than 1% after 3 months and stable corneal tomography over 9 months, with improved visual acuity. Demarcation line depth was found to be shallower than conventional CXL. Therefore, the long-term efficacy of CA-CXL requires further study.

CLINICAL TRIAL REGISTRY NUMBER: NCT04504578 Clinical trials.gov.

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