Corneal stromal demarcation line depth after corneal collagen cross-linking following conventional versus customized corneal epithelial debridement | ||
| Basrah Journal of Surgery | ||
| Article 4, Volume 28, Issue 2 - Serial Number 56, December 2022, Pages 15-20 PDF (753.83 K) | ||
| Document Type: Original Article | ||
| DOI: 10.33762/bsurg.2022.136657.1032 | ||
| Author | ||
| Salah Al-Asadi* | ||
| University of Basrah | ||
| Abstract | ||
| Aim of the Study: Using anterior segment optical coherence tomography (AS-OCT) to compare the depth of corneal demarcation line (DL) after corneal collagen cross-linking (CXL) with subtotal versus customized corneal epithelium debridement. Design: Prospective multi centric case-control study. Materials and Methods: The study enrolled 18 patients with bilateral progressive keratoconus. Both eyes treated by CXL using 3 mW/cm2 / 30 minutes setting. One eye with subtotal epithelial debridement ( about 9 mm diameter) and the contralateral eye with customized debridement ( approximately 1 mm single horizontal scratch ). One month postoperatively, patients had AS-OCT imaging to detect and measure the depth of DL. Results: Patients’ age mean was 25.17 years +/- 4.81 SD . Epithelial healing completed with in 3-7 days in conventional treatment group and demarcation line was evident in 16 eyes ( 89% ) with a mean depth of 290.31 micro m while in customized epi-off treatment group, the epithelial healing lasted less than 24 hours and DL was detectable in 10 patients ( 55.5 % ) with a mean DL depth of 221 micro m with a statistically significant difference ( p < 0.05 ) Subjective postoperative pain graded as “moderate to severe” in about 77% of eyes underwent 9 mm epi-off CXL compared with 55% of those with customized treatment. Conclusions: Although the DL if found in majority cases, but the shallow location in customized corneal debridement cases questioned the efficacy of this technique despite the quick re-epithelialization and less postoperative pain that accompanied it. | ||
| Keywords | ||
| cornea,,; ,،,؛collagen cross-linking,,; ,،,؛debridement | ||
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