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One Year Safety Analysis of Endothelial Cell Counts of Trans-Epithelial Corneal Crosslinking for Keratoconus

One Year Safety Analysis of Endothelial Cell Counts of Trans-Epithelial Corneal Crosslinking for Keratoconus. Lorelei L. Vicente, M.D. Brian S. Boxer Wachler, M.D. BEVERLY HILLS , CA. Disclosure.

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One Year Safety Analysis of Endothelial Cell Counts of Trans-Epithelial Corneal Crosslinking for Keratoconus

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  1. One Year Safety Analysis of Endothelial Cell Counts of Trans-Epithelial Corneal Crosslinking for Keratoconus Lorelei L. Vicente, M.D. Brian S. Boxer Wachler, M.D. BEVERLY HILLS , CA

  2. Disclosure Financial declaration/conflict of interest: Dr. Boxer Wachler is consultant to Addition Technology and Staar Surgical. Dr. Vicente has no financial interest in the subject matter of this paper.

  3. Purpose To assess change in endothelial cell count (ECC) of patients with keratoconus after trans-epithelial corneal collagen crosslinking with riboflavin-carboxymethylcellulose (RF-CMC).

  4. Methods • 66 eyes of 45 patients (39 +/- 14 y.o.) • Trans-Epithelial Crosslinking using 0.1 % riboflavin with 0.5% carboxymethylcellulose (RF-CMC) andTetracaine keratoconus – 56 eyes (86%) keratectasia – 10 eyes (14%) post LASIK - 8 eyes post RK - 2 eyes • 26 eyes (39%) - Trans-Epithelial Crosslinking only • 40 eyes (61%) - Intacs and Trans-Epithelial Crosslinking

  5. Methods Specular microscopy IConanNoncon ROBO SP-9900 Konan Medical Inc., Hyogo, Japan Dot method 70 contiguous cells are marked to estimate endothelial cell density

  6. Trans-Epithelial Crosslinking • Pretreatment with Tetracaine and RF-CMC • Instilled one drop after another every 5 minutes for 15 minutes • Trans-Epithelial Crosslinking Protocol RF-CMC (q 3 min.) & Tetracaine (q 10 min.) for 30 mins. • Applied via soppy, wet surgical sponges (Merocel eye spears, Medtronic, Jacksonville, FL) • Ultraviolet-A light (3.0 mW/cm2 at 370 nm)

  7. Results

  8. Conclusion Trans-Epithelial Crosslinking using 0.1% riboflavin w/ 0.5% CMC (RF-CMC) is Safe to the Endothelium

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