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Comparison of Changes in Central Corneal Thickness During Corneal Collagen Cross-Linking, Using Isotonic Riboflavin Solutions With and Without Dextran, in the Treatment of Progressive Keratoconus. | LitMetric

AI Article Synopsis

  • The study aimed to compare changes in central corneal thickness (CCT) during corneal cross-linking using two types of isotonic riboflavin solutions: one with dextran and the other with hydroxy propyl methylcellulose.
  • In a retrospective analysis of 200 cases, measurements of CCT were taken at various stages of the cross-linking process, revealing that riboflavin with dextran led to a decrease in CCT, while the dextran-free solution resulted in an increase in thickness.
  • The results indicated significant differences in CCT changes between the two groups, suggesting that the type of riboflavin used affects the corneal thickness during the cross-linking procedure.

Article Abstract

Purpose: To compare intraoperative changes in central corneal thickness (CCT) during corneal cross-linking, using 2 different isotonic riboflavin solutions either with dextran or with hydroxy propyl methylcellulose, in the treatment of progressive keratoconus.

Methods: In this retrospective study, we analyzed records of corneal thickness measurements, taken during various steps of cross-linking. Cross-linking was performed using either isotonic riboflavin with dextran (group A) or isotonic riboflavin with hydroxy propyl methylcellulose (without dextran) (group B). CCT measurements were recorded before and after epithelial removal, after saturation with respective isotonic riboflavin solution, after use of hypotonic riboflavin in selected cases, and after ultraviolet A (UV-A) application. A mixed-way analysis of variance was conducted on CCT readings within each group and between both groups, and p < 0.05 was considered significant.

Results: In group A (100 cases), after saturation with isotonic riboflavin, CCT was decreased by a mean of 51.4 μm (12.1%). In 64%, CCT was <400 μm and additional hypotonic riboflavin was used. After UV-A irradiation, CCT was decreased by a mean of 46.7 μm (11.4%). In group B (100 cases), after saturation with isotonic riboflavin, CCT was increased by a mean of 109.4 μm (26.1%). After UV-A exposure, CCT was increased by a mean of 59.2 μm (11.2%). There was a substantial main effect for time on CCT during corneal cross-linking (CXL), p < 0.001, within both groups. The main effect comparing CCT readings between groups A and B was also significant, p < 0.001.

Conclusions: During cross-linking, isotonic riboflavin with dextran causes a significant decrease in corneal thickness, whereas dextran-free isotonic riboflavin causes a significant increase in corneal thickness, thus facilitating the procedure.

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Source
http://dx.doi.org/10.1097/ICO.0000000000001496DOI Listing

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