title: Intraoperative OCT Pachymetry in Patients Undergoing Dextran-Free Riboflavin UVA Accelerated Corneal Collagen Crosslinking.
abstract: To assess intraoperative corneal pachymetry in patients undergoing accelerated corneal collagen crosslinking with a dextran-free riboflavin solution.
  
  
  
  Prospective, non-comparative, multicenter interventional study. Thirty patients with progressive keratoconus were enrolled in the study from the Siena Crosslinking Center™ in Siena, Italy and the Eye Center in Catanzaro, Italy. The mean age was 26.9 ± 6.5 years. Patients underwent pulsed light accelerated crosslinking (PL-ACXL) by KXL I UV-A source (Avedro Inc., Waltham, MS, USA) with 8 min (1 s on/1 s off) of UV-A exposure, 30 mW/cm2and an energy dose of 7.2 J/cm2. Corneal stroma was soaked with a dextran-free 0.1% riboflavin solution plus hydroxyl-propyl methylcellulose (HPMC) (VibeX Rapid, Avedro). Intraoperative corneal thickness was preoperatively (PRE-OP) evaluated by corneal optical coherence tomography (iVUE Optovue Inc., Fremont, CA, USA) after epithelium removal (EPI-R), after 10 min of riboflavin soaking (RS) and after UV-A irradiation (IR). Statistical analysis was conducted using a Wilcoxon test and SPSS v16.0. A p-value of <0.05 was considered to be statistically significant.
  
  
  
  Average PRE-OP central corneal thickness (CCT) and thinnest corneal thickness (TCT) were 437.3 ± 36.9 and 418.9 ± 28.8 μm, respectively. Average EPI-R CCT and TCT values were 388.5 ± 36.8 and 381.5 ± 36.61 μm, respectively. Average CCT and TCT values after 10 min RS were 385.2 ± 37.8 and 380.6 ± 36.7 μm, respectively. The final average CCT and TCT values after IR were 379.4 ± 37.2 and 378.1 ± 36.4 μm, respectively.
  
  
  
  The study demonstrated a non-statistically significant intraoperative corneal thickness reduction in patients undergoing PL-ACXL corneal collagen crosslinking by using dextran free HPMC 0.1% riboflavin solution.
authors.affiliation: a Eye Center , Catanzaro , Italy.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rechichi
authors.affiliation: b Ophthalmology Unit , Siena University Hospital , Siena , Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Mazzotta
authors.affiliation: c Centre for Sight , East Grinstead , UK.
authors.forename: Sheraz
authors.initials: S
authors.lastname: Daya
authors.affiliation: d Eye Clinic-Florence University , Florence , Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Mencucci
authors.affiliation: e Multidisciplinary Department of Medical , Surgical and Dental Sciences, Second University of Naples , Naples , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Lanza
authors.affiliation: f Department of Ophthalmology , University of Messina , Messina , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Meduri
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000494:pharmacology*; D003315:Cornea / Q000000981:diagnostic imaging*; D063171:Corneal Pachymetry / Q000379:methods*; D003432:Cross-Linking Reagents / Q000494:pharmacology*; D003911:Dextrans; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007640:Keratoconus / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents / Q000494:pharmacology; D011446:Prospective Studies; D012256:Riboflavin / Q000494:pharmacology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014466:Ultraviolet Rays; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D003911:Dextrans; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: Collagen crosslinking; OCT; cornea; keratoconus; pachymetry