Clinical and microstructural changes with different iontophoresis-assisted corneal cross-linking methods for keratoconus
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Qing-Yan Zeng. Hankou Aier Eye Hospital, 328 Machang Road, Wuhan 430000, Hubei Province, China. zengqingyan1972@163.com

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Supported by Natural Science Foundation of Hunan Province (No.2016JJ2163); Natural Science Foundation of Hubei Province (No.2015CFC837); Health and Family Planning Committee Science Foundation of Hubei Province (No.WJ2015MB259); Health and Family Planning Committee Science Foundation of Wuhan Municipality (No.WX17A13).

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    Abstract:

    AIM: To compare the clinical and microstructural changes induced by different transepithelial iontophoresis-assisted corneal cross-linking (I-CXL) methods for keratoconus. METHODS: A total of 42 eyes of 42 patients with progressive keratoconus were divided into two groups. Group A received I-CXL for 5min, while group B received I-CXL for 10min. Visual acuity, optical coherence tomography (OCT), specular microscopy and confocal microscopy were evaluated preoperatively and at 1, 3, 6, and 12mo postoperatively. RESULTS: Twelve months after the operation, uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) were improved in both groups, with a better outcome in the I-CXL 10min group (P=0.025, 0.021, respectively). Kmax values decreased by 0.94±3.00 D in the I-CXL 10min group (P=0.033) but increased by 1.87±3.29 D in the I-CXL 5min group (P=0.012). OCT scans showed that the demarcation line was most visible and substantially deeper in the I-CXL 10min group. Confocal microscopy showed greater anterior stromal keratocyte decreases in the I-CXL 10min group than in the I-CXL 5min group at 3 and 6mo postoperatively (P<0.001); however, anterior stromal keratocytes and subbasal nerve density were not significantly different between the two groups at 12mo postoperatively. CONCLUSION: I-CXL for 10min more effectively halts the progression of keratoconus than I-CXL for 5min after 12mo of follow-up. However, long-term studies are needed to evaluate the efficacy and safety of I-CXL.

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Kai Liao, Min Hu, Fen Chen, et al. Clinical and microstructural changes with different iontophoresis-assisted corneal cross-linking methods for keratoconus. Int J Ophthalmol, 2019,12(2):219-225

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Publication History
  • Received:January 29,2018
  • Revised:May 25,2018
  • Adopted:
  • Online: January 03,2019
  • Published: