Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus

Aim. This is a prospective interventional clinical trial to assess the depth of the demarcation line in transepithelial versus epithelium-off accelerated corneal cross-linking (AXL) in keratoconus patients. Methods. This prospective clinical trial was conducted on 40 eyes of 20 patients. Each patien...

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Main Authors: Yehia Salah, Kholoud Omar, Ahmed Sherif, Sarah Azzam
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2019/3904565
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author Yehia Salah
Kholoud Omar
Ahmed Sherif
Sarah Azzam
author_facet Yehia Salah
Kholoud Omar
Ahmed Sherif
Sarah Azzam
author_sort Yehia Salah
collection DOAJ
description Aim. This is a prospective interventional clinical trial to assess the depth of the demarcation line in transepithelial versus epithelium-off accelerated corneal cross-linking (AXL) in keratoconus patients. Methods. This prospective clinical trial was conducted on 40 eyes of 20 patients. Each patient had transepithelial AXL in one eye and epithelium-off AXL in the contralateral eye applying UVA light with an irradiance of 45 mW/cm2 for 2.4 minutes and 30 mW/cm2 for 4 minutes. The depth of the demarcation line was measured using anterior segment OCT (Topcon 3D OCT-2000) one month postoperative for both eyes. Results. The demarcation line was patchy in 50% of the transepithelial AXL eyes, the other half showing a demarcation line at a mean depth of 183 ± 41.6 μm. In the epithelium-off AXL technique, the demarcation line was well defined in all cases with a mean depth of 219 ± 27.3 μm. There was a statistically significant difference in corneal demarcation line depth between transepithelial and epithelium-off techniques (P = 0.008 and P < 0.05). The shallower demarcation line in the transepithelial group suggests that it is less effective. Conclusion. Based on the depth of the demarcation line, the cross-linking effect of epi-off AXL seems more efficacious than after transepithelial AXL. The future will show if the biomechanical effect will be sufficient to stop progression of keratoconus similarly after standard CXL. This trial is registered with NCT04045626.
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spelling doaj-art-9197eb91f75b4b9789f1f2f00dc393552025-02-03T01:25:58ZengWileyJournal of Ophthalmology2090-004X2090-00582019-01-01201910.1155/2019/39045653904565Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in KeratoconusYehia Salah0Kholoud Omar1Ahmed Sherif2Sarah Azzam3Department of Ophthalmology, Cairo University, Giza, EgyptDepartment of Ophthalmology, Cairo University, Giza, EgyptDepartment of Ophthalmology, Cairo University, Giza, EgyptDepartment of Ophthalmology, Cairo University, Giza, EgyptAim. This is a prospective interventional clinical trial to assess the depth of the demarcation line in transepithelial versus epithelium-off accelerated corneal cross-linking (AXL) in keratoconus patients. Methods. This prospective clinical trial was conducted on 40 eyes of 20 patients. Each patient had transepithelial AXL in one eye and epithelium-off AXL in the contralateral eye applying UVA light with an irradiance of 45 mW/cm2 for 2.4 minutes and 30 mW/cm2 for 4 minutes. The depth of the demarcation line was measured using anterior segment OCT (Topcon 3D OCT-2000) one month postoperative for both eyes. Results. The demarcation line was patchy in 50% of the transepithelial AXL eyes, the other half showing a demarcation line at a mean depth of 183 ± 41.6 μm. In the epithelium-off AXL technique, the demarcation line was well defined in all cases with a mean depth of 219 ± 27.3 μm. There was a statistically significant difference in corneal demarcation line depth between transepithelial and epithelium-off techniques (P = 0.008 and P < 0.05). The shallower demarcation line in the transepithelial group suggests that it is less effective. Conclusion. Based on the depth of the demarcation line, the cross-linking effect of epi-off AXL seems more efficacious than after transepithelial AXL. The future will show if the biomechanical effect will be sufficient to stop progression of keratoconus similarly after standard CXL. This trial is registered with NCT04045626.http://dx.doi.org/10.1155/2019/3904565
spellingShingle Yehia Salah
Kholoud Omar
Ahmed Sherif
Sarah Azzam
Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
Journal of Ophthalmology
title Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
title_full Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
title_fullStr Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
title_full_unstemmed Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
title_short Study of Demarcation Line Depth in Transepithelial versus Epithelium-Off Accelerated Cross-Linking (AXL) in Keratoconus
title_sort study of demarcation line depth in transepithelial versus epithelium off accelerated cross linking axl in keratoconus
url http://dx.doi.org/10.1155/2019/3904565
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