[Transepithelial iontophoresis corneal collagen cross-linking for progressive XXXX : one year results].

@entity1 @entity1066 @entity28680 @entity260 @entity281 @entity9042 @entity158
OBJECTIVE: To evaluate the early clinical results of keratoconic eyes treated with transepithelial iontophoresis corneal collagen cross-linking (i-CXL) within 1 year. METHODS: Propective nonrandomized study. Twenty-three eyes of 23 @entity1 with progressive @entity9042 with minimum corneal thickness from 380   m to 420   m (including the epithelium) were included in this prospective, nonrandomized clinical study and treated with i-CXL. Scoring of @entity158 , slit lamp examination, uncorrected visual acuity (UCVA) and best corrected distance visual acuity (BCVA), corneal topography, anterior segment optical coherence tomography (AS-OCT), in vivo corneal confocal microscopy and endothelial cell count were assessed before surgery and at 1, 3, 6 and 12 months (m) postoperatively. Paired t test was applied for statistical analysis. RESULTS: Moderate @entity158 were reported by most @entity1 on postoperative Day (D) 1, but rapidly decreased and eventually disappeared on D3. Mild epithelial damage was observed on D1, and the epithelium fully recovered on D3. Improvement of UCVA and BCVA were recorded at 3 months and 12 months postoperatively. Orbscan II corneal topography revealed the significant reductions of Kmax and @entity28680 from 3m to 12m (Kmax, t = 2.912, P < 0.01, @entity28680 , t = 2.508, P < 0.05) postoperatively while the other parameters remained stable. The Kmax and @entity28680 at 12m was (52.94    4.87) and (46.78    3.71) respectively, while the preoperative values was (54.37    5.56) and (48.53    3.57) respectively. Within 1m postoperatively, AS-OCT exhibited an increase of reflectance with a white line (demarcation line) in the anterior stroma, in vivo confocal microscopy also showed the significant thickening and increased connections of collagen fibers with maximal depth of about 133   m. The corneal endothelial cell density remained stable (t = 0.915, P > 0.05). None of the @entity1 showed @entity260 such as @entity281 , scarring, @entity1066 , persistent epithelial defect, etc. CONCLUSIONS: Priliminary clinical results within 1 year postoperatively demonstrated the efficacy and safety of i-CXL for the management of progressive @entity9042 . This technique was applicable for keratoconic eyes with minimum corneal thickness around 400   m. i-CXL showed the advantage of short time consuming in surgery, rapid recovery and few complication, and has the potential to become a valid alternative for the treatment of @entity9042 .
