title: Recovery of corneal sensitivity after collagen crosslinking with and without epithelial debridement in eyes with keratoconus.
abstract: OBJECTIVE
  To evaluate the changes in corneal sensitivity after corneal collagen crosslinking (CXL) with the epithelium off (epi-off) and with the epithelium on (epi-on) in eyes with keratoconus.
  
  
  METHODS
  Prospective interventional case series.
  
  
  METHODS
  Eye Clinic, A. Fiorini Hospital, Terracina (Latina), Rome, Italy.
  
  
  METHODS
  On the basis of the corneal pachymetry at the area of topographic steepening, eyes treated with CXL were divided in 2 groups: those with a corneal thickness of 400 μm or more (epi-off) and those with a corneal thickness of less than 400 μm (epi-on). Corneal sensitivity was measured using a contact esthesiometer (Cochet-Bonnet) before treatment and 1 and 7 days and 1, 3, 6, 9, and 12 months after treatment.
  
  
  RESULTS
  The study evaluated 50 CXL-treated eyes in 50 patients (25 epi-on and 25 epi-off) from January 7, 2012, to December 15, 2012. In the epi-off group, corneal sensitivity was statistically significantly reduced for up to 3 months after CXL and gradually returned to normal levels. In the epi-on group, corneal sensitivity was statistically significantly reduced for up to 7 days but was not statistically significantly different from preoperative values at other measurement times. At 7 days, the corneal sensitivity was statistically significantly lower in the epi-off eyes than in the epi-on eyes.
  
  
  CONCLUSIONS
  Epi-off and epi-on CXL both caused hypoesthesia, but corneal sensitivity subsequently recovered completely. The corneal hypoesthesia was more pronounced in eyes in which the epi-off technique was used, and the recovery time was shorter for eyes treated using epi-on CXL.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Department of Biotechnology and Medical-Surgical Sciences, Latina (Spadea, Salvatore, Vingolo), and the Department of Ophthalmology, Rome (Paroli), Sapienza University of Rome, Italy. Electronic address: leopoldo.spadea@uniroma1.it.
authors: Leopoldo
authors: L
authors: Spadea
authors: From the Department of Biotechnology and Medical-Surgical Sciences, Latina (Spadea, Salvatore, Vingolo), and the Department of Ophthalmology, Rome (Paroli), Sapienza University of Rome, Italy.
authors: Serena
authors: S
authors: Salvatore
authors: From the Department of Biotechnology and Medical-Surgical Sciences, Latina (Spadea, Salvatore, Vingolo), and the Department of Ophthalmology, Rome (Paroli), Sapienza University of Rome, Italy.
authors: Maria Pia
authors: MP
authors: Paroli
authors: From the Department of Biotechnology and Medical-Surgical Sciences, Latina (Spadea, Salvatore, Vingolo), and the Department of Ophthalmology, Rome (Paroli), Sapienza University of Rome, Italy.
authors: Enzo Maria
authors: EM
authors: Vingolo
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003315:Cornea / Q000502:physiology*; D063171:Corneal Pachymetry; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D003646:Debridement; D019573:Epithelium, Corneal / Q000601:surgery*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D020127:Recovery of Function; D012256:Riboflavin / Q000627:therapeutic use; D012677:Sensation / Q000502:physiology*; D014466:Ultraviolet Rays; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin