TY  - JOUR
TI  - Epithelium-off corneal cross-linking versus transepithelial  diluted alcohol and iontophoresis-assisted corneal cross linking in keratoconus patients with thin corneas
AB  - Aims: To evaluate the efficacy and safety of transepithelial diluted alcohol and iontophoresis assisted corneal cross-linking (DAI-CXL) and compare 24-month visual and topographic  outcomes with accelerated CXL using hypo-osmolar riboflavin (A-CXL) in keratoconus patients  with thin corneas (below 400 μm with epithelium). Methods: This retrospective study included keratoconus patients who underwent DAI-CXL or  A-CXL. Uncorrected and corrected distance visual acuity (UDVA and CDVA) and data obtained  from corneal topography were analyzed at baseline and 12 and 24 months of follow-up.  Corneal demarcation line depth (DLD) at 1 month and corneal endothelial cell density (ECD) at  24 months were also evaluated.  Results: The study included 25 eyes of 25 keratoconus patients (mean age: 25.48±6.69 years,  male: 52%). DAI-CXL and A-CXL groups consisted of 13 and 12 patients, respectively. In both  groups, median UDVA improved significantly at 24 months (p<0.05) whereas CDVA was similar  despite a trend towards improvement. Median K-max decreased by 2.77 [interquartile range  (IQR): 2.67] D and 2.24 (IQR: 4.38) D in DAI-CXL group (p=0.033) and A-CXL group (p=0.060),  respectively. Corneal HOAs showed a significant improvement in only the DAI-CXL group  (p=0.004). Average DLD was 237±67 μm in DAI-CXL and 242±57 μm in A-CXL (p=0.346). No  significant changes in ECD were observed in both groups. Median follow-up changes in UDVA,  CDVA, K-max, HOAs, and ECD were similar in the groups.  Conclusions: We observed similar efficacy of transepithelial DAI-CXL to A-CXL in slowing down  the progression of keratoconus in thin corneas without notable effects during a 24-month  follow-up period.
AU  - Yüksel, Murat
AU  - Ozmen, Mehmet
AU  - Aydın, Bahri
AU  - Uysal, Betul Seher
DO  - 10.4274/gulhane.galenos.2022.75437
PY  - 2022
JO  - Gülhane Tıp Dergisi
VL  - 64
IS  - 3
SN  - 1302-0471
SP  - 255
EP  - 261
DB  - TRDizin
UR  - http://search/yayin/detay/1124098
ER  -