Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 5 Issue 4

Outcome of Epithelium-on Versus Epithelium-off Corneal Collagen Cross-linking in Keratoconus

Shaikh Jannatul Kabir1, Md Sharfuddin Ahmed2, Md Showkat Kabir3, Mohammad Shish Rahman4, Nirupam Chowdhury4, Mohammed Moinul Hoque4 and Nawreen Binte Anwar5*

1Resident, Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2Vice Chancellor, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3Associate Professor, Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3Assistant Professor, Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4Medical Officer, Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

*Corresponding Author: Nawreen Binte Anwar, Medical Officer, Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Received: March 17, 2022; Published: March 22, 2022

Abstract

Purpose: To compare and measure the epithelium on versus epithelium off corneal collagen cross linking in the treatment of keratoconus.

Methods: This interventional study was conducted in the Department of Community Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh and Green Eye Hospital, Dhanmondi, Dhaka, from January 2020 to September 2021. Forty patients with keratoconus were randomly selected to one of the two treatment groups. Twenty patients treated with epithelium on CXL were considered Group I (n = 20), and the other 20 patients treated with epithelium off CXL were considered Group II.

Results: The mean age was 21.95 ± 4.19 years in group I and 20.9 ± 3.35 years in group II. The mean BCVA was 0.48 ± 0.42 logMAR unit in group I and 0.45 ± 0.27 logMAR unit in group II. Keratometry values remain unchanged in both groups except the mean simulated maximum keratometry readings. The simulated maximum keratometry in postoperative day-15 was 52.68 ± 4.02 diopters in group I and 56.51 ± 5.21 diopters in group II. The mean simulated maximum keratometry postoperative day-30 was 52.96 ± 4.02 diopters in group I and 56.6 ± 5.31 diopters in group II. The mean corneal thickness preoperatively was 450.5 ± 38.4 μm in group I and 445.5 ± 33.89 μm in group II. The mean postoperative corneal thickness on day-15 and 30 was 451.85+-38.22 and 451.6 ± 38.43 μm in group I and 437.9+31.38 μm and 438.5 ± 33.51 μm in group II respectively. The mean OSDI preoperative was 16.3 ± 2.23 in group I and 15.2 ± 2.07 in group II. The mean OSDI on postoperative day-1 was 17.15 ± 2.21 in group I and 15.75 ± 2.07 in group II. The mean OSDI on postoperative day-30 was 15.4 ± 2.11 in group I and 15.9 ± 2.38 in group II. The improvement was not statistically significant.

Conclusion: Both procedures can halt the progression of keratoconus. In terms of results and related complications, both treatment procedures are equivalent.

Keywords: Corneal Collagen Cross-linking; Epithelium-Off; Epithelium-on; Keratoconus

References

  1. Akbar Bushra., et al. “Comparison of transepithelial corneal crosslinking with epithelium-off crosslinking (epithelium-off CXL) in adult Pakistani population with progressive keratoconus”. Taiwan Journal of Ophthalmology4 (2017): 185-190.
  2. Boyd K. “What Is Keratoconus?” American Academy of Ophthalmology (2020).
  3. Yuksel Erdem., et al. “Accelerated epithelium-on or accelerated epithelium-off corneal collagen cross-linking: Contralateral comparison study”. Taiwan Journal of Ophthalmology1 (2020): 37-44.
  4. Mastropasqua Leonardo. “Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives”. Eye and vision (London, England)19 (2015).
  5. Feldman BH., et al. Corneal Collagen Cross-Linking. Sept. (2021).
  6. Espandar Ladan and Jay Meyer. “Keratoconus: overview and update on treatment”. Middle East African Journal of Ophthalmology1 (2010): 15-20.
  7. Nawaz Shah., et al. “Trans-epithelial versus conventional corneal collagen crosslinking: A randomized trial in keratoconus”. Oman Journal of Ophthalmology1 (2015): 9-13.
  8. Cifariello F., et al. “Epi-Off versus Epi-On Corneal Collagen Cross-Linking in Keratoconus Patients: A Comparative Study through 2-Year Follow-Up”. Journal of Ophthalmology (2018): 4947983.
  9. El-malah Mohamed Ahmed Ahmed., et al. ‘Epithelium-On Versus Epithelium-Off Corneal Collagen Cross-Linking for The Management of Keratoconus”. The Egyptian Journal of Hospital Medicine1 (2019): 3273-3281.
  10. Beckman Kenneth A. “Epithelium-on Corneal Collagen Cross-Linking with Hypotonic Riboflavin Solution in Progressive Keratoconus”. Clinical ophthalmology (Auckland, N.Z.) 15 (2021): 2921-2932.
  11. Goldich Yakov., et al. “Corneal collagen cross-linking for the treatment of progressive keratoconus: 3-year prospective outcome”. Canadian Journal of Ophthalmology 49,1 (2014): 54-59.
  12. Lombardo Marco., et al. “Randomized Controlled Trial Comparing Transepithelial Corneal Cross-linking Using Iontophoresis with the Dresden Protocol in Progressive Keratoconus”. Ophthalmology6 (2017): 804-812.
  13. Kobashi Hidenaga., et al. “Transepithelial versus epithelium-off corneal crosslinking for corneal ectasia”. Journal of Cataract and Refractive Surgery12 (2018): 1507-1516.
  14. Cantemir Alina,., et al. ‘Evaluation of Iontophoretic Collagen Cross-Linking for Early Stage of Progressive Keratoconus Compared to Standard Cross-Linking: A Non-Inferiority Study’. Ophthalmology Therapy1 (2017): 147-160.
  15. Raiskup Frederik., et al. ‘Corneal Collagen Crosslinking with Riboflavin and Ultraviolet-A Light in Progressive Keratoconus: Ten-Year Results’. Journal of Cataract and Refractive Surgery1 (2015).
  16. Arance-Gil Ángeles., et al. “Epithelium-Off vs. transepithelial corneal collagen crosslinking in progressive keratoconus: 3 years of follow-up”. Journal of Optometry2 (2021): 189-198.

Citation

Citation: Nawreen Binte Anwar., et al. “Outcome of Epithelium-on Versus Epithelium-off Corneal Collagen Cross-linking in Keratoconus".Acta Scientific Ophthalmology 5.4 (2022): 59-65.

Copyright

Copyright: © 2022 Nawreen Binte Anwar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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