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Corneal thickness optimized by preoperative swelling or shriveling of corneal stroma
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BARCELONA — Preoperative swelling or shriveling of corneal stroma is a promising method to optimize the corneal thickness of cross-linking, a presenter said here.
"Limiting the area of corneal cross-linking in the case of keratoconus and centering it according to topography of the cone is increasing the refractive effectiveness of cross-linking," Averanova Oksana, MD, said at the European Society of Cataract and Refractive Surgeons meeting.
Dr. Oksana studied 100 eyes with progressive keratoconus, 10 eyes with keratitis and 10 eyes with erythema elevatum diutinum. All eyes were treated with cross-linking and an UV-XTM radiation. She used a hypo-osmolar solution of 0.1% riboflavin for corneal swelling and hyperosmolar for corneal shriveling before UV irradiation. The cross-linking area was limited by decreasing a de-epithelialized area up to 5.5 mm and decentering it according to the topographic location of the apex of the cone.
Dr. Oksana said all of the keratoconus eyes with initial thinning of the corneas up to 300 µm swelled to 400 µm. Corneas with erythema elevatum diutinum shriveled up to 200 µm, whereas the corneas with keratitis were the least responsive with 70 µm of shriveling.