Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up

Purpose. The aim of our study was to compare the long-term efficacy and safety of “epi-off” conventional and “epi-off” accelerated corneal cross-linking (CXL) in patients with progressive keratoconus. Methods. “Epithelial-off” (“Epi-off”) CXL using the conventional technique (3 mW/cm2, 30 minutes) w...

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Main Authors: Cristina Ariadna Nicula, Dorin Nicula, Anca Maria Rednik, Adriana Elena Bulboacă
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/4745101
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author Cristina Ariadna Nicula
Dorin Nicula
Anca Maria Rednik
Adriana Elena Bulboacă
author_facet Cristina Ariadna Nicula
Dorin Nicula
Anca Maria Rednik
Adriana Elena Bulboacă
author_sort Cristina Ariadna Nicula
collection DOAJ
description Purpose. The aim of our study was to compare the long-term efficacy and safety of “epi-off” conventional and “epi-off” accelerated corneal cross-linking (CXL) in patients with progressive keratoconus. Methods. “Epithelial-off” (“Epi-off”) CXL using the conventional technique (3 mW/cm2, 30 minutes) was performed in 93 eyes of 93 patients (S-CXL group) and “epi-off” accelerated method (9 mW/cm2, 10 minutes) in 76 eyes of 76 patients with progressive KCN (A-CXL group). Cases with different stages of keratoconus and topographic evidence of progression were included. Main outcomes comprised refraction, keratometry measurements, uncorrected (UCVA) and best-corrected visual acuity (BCVA), and topographical indices. Micromorphological analysis was assessed by anterior segment ocular coherence tomography (AS-OCT). The follow-up period was 5 years. Results. In both groups, Kflat presented similar results: decrease at 1 year (p=0.465), at 2 years (p=0.672), at 3 years (p=0.198), at 4 years (p=0.32), and at 5 years (p=0.864). In both groups, Ksteep presented a similar decrease at 1 year (p=0.709), at 2 years (p=0.455), at 3 years (p=0.43), at 4 years (p=0.57), and at 5 years (p=0.494), with no statistically significant difference. Decrease in Kavg was similar in both groups at all analyzed time points (p=0.18 at 1 year, p=0.093 at 2 years, p=0.57 at 3 years, p=0.154 at 4 years, and p=0.247 at 5 years). Kmax had a similar decrease in both groups at 1 year (p=0.06), at 2 years (p=0.09), at 3 years (p=0.126), at 4 years (p=0.113), and at 5 years (p=0.114). There was no statistically significant difference between the cylinder decrease in both groups (p=0.349 at 1 year, p=0.6782 at 2 years, p=0.299 at 3 years, p=0.0943 at 4 years, and p=0.144 at 5 years). The BCVA values were statistically significantly higher than the preoperative values in both groups at all time points (p<0.05). Topographical indices such as thinnest corneal point (TP), corneal volume (CV), index vertical asymmetry (IVA), index of vertical asymmetry (ISV), index of height asymmetry (IHA), index of height decentration (IHD), Belin/Ambrosio Enhanced Ectasia Display (BAD_D), and Ambrosio retinal thickness (ART Max) were significantly statistically decreased compared with baseline at all time points, in both groups. Conclusion. “Epi-off” accelerated and conventional CXL have the same efficacy in terms of improvement in visual and topographic outcomes.
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spelling doaj-art-23f2842f9cba46519b4940a106c7ab1c2025-02-03T05:44:16ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/47451014745101Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-UpCristina Ariadna Nicula0Dorin Nicula1Anca Maria Rednik2Adriana Elena Bulboacă3Department of Ophthalmology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaOculens Clinic, Cluj-Napoca, RomaniaCounty Eye Hospital, Cluj-Napoca, RomaniaDepartment of Physiopathology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaPurpose. The aim of our study was to compare the long-term efficacy and safety of “epi-off” conventional and “epi-off” accelerated corneal cross-linking (CXL) in patients with progressive keratoconus. Methods. “Epithelial-off” (“Epi-off”) CXL using the conventional technique (3 mW/cm2, 30 minutes) was performed in 93 eyes of 93 patients (S-CXL group) and “epi-off” accelerated method (9 mW/cm2, 10 minutes) in 76 eyes of 76 patients with progressive KCN (A-CXL group). Cases with different stages of keratoconus and topographic evidence of progression were included. Main outcomes comprised refraction, keratometry measurements, uncorrected (UCVA) and best-corrected visual acuity (BCVA), and topographical indices. Micromorphological analysis was assessed by anterior segment ocular coherence tomography (AS-OCT). The follow-up period was 5 years. Results. In both groups, Kflat presented similar results: decrease at 1 year (p=0.465), at 2 years (p=0.672), at 3 years (p=0.198), at 4 years (p=0.32), and at 5 years (p=0.864). In both groups, Ksteep presented a similar decrease at 1 year (p=0.709), at 2 years (p=0.455), at 3 years (p=0.43), at 4 years (p=0.57), and at 5 years (p=0.494), with no statistically significant difference. Decrease in Kavg was similar in both groups at all analyzed time points (p=0.18 at 1 year, p=0.093 at 2 years, p=0.57 at 3 years, p=0.154 at 4 years, and p=0.247 at 5 years). Kmax had a similar decrease in both groups at 1 year (p=0.06), at 2 years (p=0.09), at 3 years (p=0.126), at 4 years (p=0.113), and at 5 years (p=0.114). There was no statistically significant difference between the cylinder decrease in both groups (p=0.349 at 1 year, p=0.6782 at 2 years, p=0.299 at 3 years, p=0.0943 at 4 years, and p=0.144 at 5 years). The BCVA values were statistically significantly higher than the preoperative values in both groups at all time points (p<0.05). Topographical indices such as thinnest corneal point (TP), corneal volume (CV), index vertical asymmetry (IVA), index of vertical asymmetry (ISV), index of height asymmetry (IHA), index of height decentration (IHD), Belin/Ambrosio Enhanced Ectasia Display (BAD_D), and Ambrosio retinal thickness (ART Max) were significantly statistically decreased compared with baseline at all time points, in both groups. Conclusion. “Epi-off” accelerated and conventional CXL have the same efficacy in terms of improvement in visual and topographic outcomes.http://dx.doi.org/10.1155/2020/4745101
spellingShingle Cristina Ariadna Nicula
Dorin Nicula
Anca Maria Rednik
Adriana Elena Bulboacă
Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
Journal of Ophthalmology
title Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
title_full Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
title_fullStr Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
title_full_unstemmed Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
title_short Comparative Results of “Epi-Off” Conventional versus “Epi-Off” Accelerated Cross-Linking Procedure at 5-year Follow-Up
title_sort comparative results of epi off conventional versus epi off accelerated cross linking procedure at 5 year follow up
url http://dx.doi.org/10.1155/2020/4745101
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