In:
Journal of Refractive Surgery, SLACK, Inc., Vol. 35, No. 3 ( 2019-03), p. 184-190
Abstract:
To compare the 2-year follow-up outcomes of three groups of patients with keratoconus treated with transepithelial iontophoresis (I-CXL), iontophoresis with epithelial removal (I-SCXL), and standard epithelium-off (S-CXL) CXL for progressive keratoconus. METHODS: Sixty eyes of 60 patients treated with CXL for progressive keratoconus were included in this comparative, prospective clinical study. Twenty patients were included in each group (I-CXL, I-SCXL, and S-CXL). Corrected distance visual acuity (CDVA), refraction, corneal topography, Scheimpflug tomography, and aberrometry were assessed at baseline and at 1, 3, 6, 12, and 24 months of follow-up. To assess the long-term safety and efficacy of these treatments, the preoperative values were compared with the values at 24 months of follow-up. RESULTS: The main outcome of the study was the non-statistically significant difference between the three protocols in induced change in most of the parameters, including visual acuity ( P = .665), topographic indexes (all P 〉 .05), and maximum keratometry ( P = .611) after 2 years of follow-up. There were no significant differences in the change in refractive error following CXL in all groups or between groups (all P 〉 .05). Conversely, I-CXL induced significantly less corneal thinning ( P = .0299 and .0121) and a significantly greater reduction of higher order aberrations and coma (all P 〈 .0001) compared to S-CXL and I-SCXL. All protocols induced a significant increase in visual acuity (S-CXL P = .0004, I-SCXL P = .0045, and I-CXL P = .004). CONCLUSIONS: The 2-year results of this comparative, prospective clinical study demonstrate the efficacy and safety of I-CXL to treat progressive keratoconus and overcome the limitations of CXL with epithelial debridement. [ J Refract Surg . 2019;35(3):184–190.]
Type of Medium:
Online Resource
ISSN:
1081-597X
DOI:
10.3928/1081597X-20190128-01
Language:
English
Publisher:
SLACK, Inc.
Publication Date:
2019
