Topographic Changes in Keratoconic Patients after Transepithelial (Epi-On) Collagen Cross-Linking

Objectives: To evaluate corneal changes as measured by Pentacam before and after transepithelial corneal collagen cross-linking in cases of Keratoconus. Study design: A prospective consecutive case series study carried out at a private lasik centre Patients and Methods: 74 eyes of 50 patients with progressive keratoconus underwent transepithelial (Epi-on) CXL using both ParaCelTM and vibeX-Xtra. Baseline examination included: full ocular examination, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal topography using PentacamTM to determine; flat corneal curvature (K1), steep corneal curvature (K2), mean corneal curvature (Km), corneal astigmatism, corneal thickness at the thinnest location and posterior surface elevation at the highest point in the central 5 mm. The follow-up visits were scheduled on 3 and 6 months after treatment by checking the BCVA, PentacamTM. Results: Our results showed an improvements in BCVA at the end of the 6th month post operative that showed an increase from 0.48 to 0.54 and this was statistically significant (P value 0.007) (<0.01), Pentacam topographic changes were found to be decreased postoperatively and were found to be statistically insignificant. Conclusion: In this study, with a follow-up for 6 months, we found the transepithelial corneal collagen cross- linking is beneficial and safe for patients with keratoconus. Transepithelial CXL treatment appeared to halt keratoconus progression, with a statistically significant improvement in visual acuity by stabilizing or partially reversing the keratectasia process.