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Epi-on cross-linking with iontophoresis encouraging but needs longer follow-up
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PARIS — A study evaluating the efficacy of transepithelial cross-linking with iontophoresis for riboflavin penetration showed encouraging results at 6 months.
The study included 45 patients treated in two university centers, Brest and Toulouse, in France. Instillation of riboflavin was followed by application of a low electric current flow for 5 minutes and UV irradiation for a further 9 minutes. A second group of patients was treated with the conventional epi-off cross-linking procedure.
Ivan Delafoy
“Fluorometry performed during the procedure showed that riboflavin penetration is 2.5-fold less with the iontophoresis procedure compared to conventional. At 1 month, a demarcation line was present in 96% of the eyes treated with conventional CXL and in 50% of the eyes treated with the iontophoresis procedure. Depth of the line, when present, was also slightly inferior,” Ivan Delafoy, MD, said at the meeting of the French Society of Ophthalmology.
Confocal microscopy showed a less intense and less deep activation of keratocytes in the corneas treated with iontophoresis and comparable denervation in the two groups.
“At 6 months, keratometry values were stable in both groups, showing comparable stabilization of the disease with the two methods. However, 12-month evaluation is necessary,” Delafoy said.
An increased dose of irradiation could be considered to possibly enhance results of the iontophoresis technique, he said.
Disclosure: Delafoy has no relevant financial disclosures.