Iontophoretic Transepithelial Collagen Cross-Linking Versus Epithelium-Off Collagen Cross-Linking in Pediatric Patients: 3-Year Follow-Up

Luca Buzzonetti, Gianni Petrocelli, Paola Valente, Giancarlo Iarossi, Roberta Ardia, Sergio Petroni, Rosa Parrilla

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: To compare 3-year iontophoretic transepithelial corneal cross-linking (I-ON CXL) outcomes with epithelium-off collagen cross-linking (epi-off CXL) in pediatric patients.Methods: Forty eyes of 28 consecutive pediatric patients [mean age 14.3+/-2.5 (SD) years; range, 9-18 years] with keratoconus were evaluated. Twenty eyes of 15 patients underwent I-ON and 20 eyes of 13 patients epi-off CXL. Mean corrected distance visual acuity, spherical equivalent, maximum keratometry (Kmax), posterior elevation of the thinnest point, and thickness of the thinnest point were evaluated. The Student t test was used to compare baseline and postoperative data. Keratoconus progression as a function of preoperative Kmax and cone location was evaluated.Results: At 36 months, corrected distance visual acuity statistically improved (from 0.18+/-0.1 to 0.10+/-0.1 logarithm of the minimum angle of resolution) in epioff CXL, whereas spherical equivalent and posterior elevation of the thinnest point did not significantly change. Mean Kmax increased from the baseline +0.8 diopters (D) in epi-off and +2.9D in I-ON. In both groups, the thinnest point decreased. Keratoconus progression, defined by an increase of Kmax reading of the anterior corneal surface of at least 1.00D, occurred in 25% of epi-off and 50% of I-ON CXL over the 3-year period. Kmax value in I-ON, and cone location in both groups, seemed to be factors influencing the disease progression.Conclusions: In pediatric patients, 3 years after treatment, epi-off CXL halted keratoconus progression in 75% of eyes, whereas I-ON CXL seemed to slow down keratoconus progression in 50% of eyes, mainly in those with highest Kmax and paracentral cone.
Original languageEnglish
Pages (from-to)859-863
Number of pages5
JournalCornea
Volume38
DOIs
Publication statusPublished - 2019

Keywords

  • Adolescent
  • Child
  • Collagen
  • Cross-Linking Reagents
  • Female
  • Follow-Up Studies
  • Humans
  • Iontophoresis
  • Keratoconus
  • Male
  • Photochemotherapy
  • Photosensitizing Agents
  • Refraction, Ocular
  • Riboflavin
  • Ultraviolet Rays
  • Visual Acuity
  • epithelium-off corneal cross-linking
  • iontophoresis transepithelial corneal cross-linking
  • keratoconus
  • pediatric patients

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