title: Customized pachymetric guided epithelial debridement for corneal collagen cross linking.
abstract: BACKGROUND
  We describe a modified method for deepitheliazation prior to corneal cross linking (CXL). The technique may overcome the current corneal pachymetric limitation parameter (over 400 microns) that is necessary for the safety of the procedure without affecting the overall benefits.
  
  
  METHODS
  In a series of two patients, with inferior topographic steepening and regional thinning (less than 400 microns corresponding to the area of corneal steepening), CXL after customized epithelial removal was performed.
  
  
  RESULTS
  There were no intra- or postoperative adverse events seen by the nine month follow up examination. Stabilization of the corneal ectasia was observed up to nine months post-costumized pachymetric-guided epithelial removal.
  
  
  CONCLUSIONS
  The technique of customized pachymetric-guided epithelial removal is easy to perform and may overcome the limitations of the preoperative corneal pachymetry expanding the application of the procedure in patients with regional corneal thinning.
authors.affiliation: Institute of Vision & Optics, Department of Medicine, University of Crete, Crete, Greece. kymionis@med.uoc.gr
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Vasilios F
authors.initials: VF
authors.lastname: Diakonis
authors.forename: Efekan
authors.initials: E
authors.lastname: Coskunseven
authors.forename: Mirco
authors.initials: M
authors.lastname: Jankov
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
authors.forename: Ioannis G
authors.initials: IG
authors.lastname: Pallikaris
mesh_terms: D003094:Collagen / Q000528:radiation effects* / Q000648:ultrastructure; D003316:Corneal Diseases / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003319:Corneal Stroma / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery; D003646:Debridement / Q000379:methods*; D019573:Epithelium, Corneal / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
chemical_list: D003094:Collagen