Citation:Abdel-Radi M, Eldaly Z, Abdelmotaal H, Abdelrahman R, Sayed M, Soliman K. Correlation between corneal demarcation line depth in epithelium-off and trans-epithelium accelerated corneal cross linking and keratoconus progression. Int J Ophthalmol 2020;13(6):907-912,doi:10.18240/ijo.2020.06.08
Correlation between corneal demarcation line depth in epithelium-off and trans-epithelium accelerated corneal cross linking and keratoconus progression
Received:July 20, 2019  Revised:October 08, 2019
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DOI:10.18240/ijo.2020.06.08
Key Words:anterior segment optical coherence tomography  cross linking  demarcation line  keratoconus
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Mahmoud Abdel-Radi Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
Zeiad Eldaly Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
Hazem Abdelmotaal Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
Reham Abdelrahman Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
Mohamed Sayed Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
Kamel Soliman Department of Ophthalmology, Assiut University, Assiut 71516, Egypt
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Abstract:
      AIM: To compare corneal demarcation line (DL) depth in both accelerated epithelium-off and trans-epithelium cross linking (CXL) using anterior segment optical coherence tomography (AS-OCT) and its relation to maximum keratometry (Kmax) progression in both techniques.

    METHODS: A prospective comparative interventional study where patients with mild to moderate keratoconus (KC) were classified into two groups: accelerated epithelium-off and trans-epithelium CXL based on corneal pachymetry. Assessment of corneal DL depth was carried out after 3mo by AS-OCT. Kmax readings were evaluated after one year follow up using the Scheimpflug imaging system.

    RESULTS: Study included 74 eyes of 44 patients. Group A underwent epithelium-off CXL (41 eyes), while Group B underwent trans-epithelium CXL (33 eyes). At 3mo follow up, mean corneal DL depth in Group A was 219.9±58.4 μm while in Group B was 127.2±7.8 μm (P<0.05). The mean Kmax changed from 51.9±3.9 to 51.3±4.2 diopters in Group A and from 53.1±4.1 to 53.6±5 diopters in Group B with insignificant difference in Kmax changes in either group (P>0.05). In addition, no significant change in corneal pachymetry was found in both groups (mean change at 1y: 6.4±4.7 and -10.1±2.3 μm in Groups A and B respectively).

    CONCLUSION: Despite a significantly deeper corneal DL depth created by accelerated epithelium-off CXL technique compared to accelerated trans-epithelium CXL, there is no significant impact on keratoconus progression.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270254/
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