Long-term Analysis of Epi-ON Corneal Collagen Cross-linking Outcomes in Corneal Ectasia

JOURNAL TITLE: International Journal of Keratoconus and Ectatic Corneal Diseases

1. Vicente Rodriguez
2. Rafael Melián
3. Jesús M Gonzalez-Martín
4. David P Piñero Llorens
5. Humberto Carreras
6. Francisco Galván
Publishing Year
  • Article keywords
    Corneal collagen cross-linking, Corneal ectasia, Corneal tomography, Keratoconus, Pellucid marginal degeneration, Post-LASIK ectasia


    Aim and objective: To evaluate the 3-year follow-up clinical outcomes obtained in corneal ectasia using Epi-ON corneal collagen cross-linking (CXL). Materials and methods: This study is a retrospective study enrolling 46 eyes from 32 patients with progressive corneal ectasia and treated with Epi-ON CXL in the period from September 2012 to April 2016. Two groups were differentiated according to the type of corneal ectasia: ectasia post-LASIK group (EPL, 12 eyes) and primary ectasia group (34 eyes). Two different platforms were used for the surgical protocol: VEGA CBM X LINKER platform (CSO, Firenze, Italy) and KXL (Avedro, Waltham, Massachusetts, USA). Visual, refractive, and corneal tomographic outcomes were evaluated during a 3-year follow-up. Results: A statistically significant improvement in the logMAR corrected distance visual acuity (CDVA) was observed in the whole sample (p <0.001) during the follow-up, with half of the sample improving one or more lines of CDVA. Likewise, only significant changes were detected in steepest keratometry (p <0.001), corneal astigmatism (p = 0.012), and index of height asymmetry (p = 0.021), with a trend to increase. Regarding the comparison between groups, more significant improvement in CDVA was found in the EPL group compared to the primary ectasia group (−0.07 ± 0.09 vs −0.15 ± 0.14, p = 0.028). Likewise, a significant trend to more corneal thinning was observed in primary ectasia group (p = 0.034). Conclusion: Epi-ON CXL is efficacious for stabilizing the progression of primary and iatrogenic ectasias for most cases, with significant improvement of visual acuity associated.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved