title: Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results.
abstract: Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL). Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT), and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map. Results. Functional parameters showed a significant improvement (p < 0.05) of BSCVA after 3 and 6 months of follow-up. Morphological parameters indicated stabilization of the corneal ectasia during the follow-up; however, a positive trend was noted with a mean flattening of 1.73 D. Minimum pachymetry values showed thinning that remained constant after the treatment. The demarcation line was clearly visible in all patients, reaching a depth of 308.2 ± 37.74 μm. None of the patients had continuous progression of keratoconus or had to repeat cross-linking procedures. Endothelial cell counts did not change significantly (p > 0.05). Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion.
authors.affiliation: Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy; Humanitas University, Rozzano, 20089 Milan, Italy.
authors.forename: Paolo
authors.identifier: 0000-0002-3864-8246
authors.initials: P
authors.lastname: Vinciguerra
authors.affiliation: Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool L7 8XP, UK.
authors.forename: Vito
authors.identifier: 0000-0002-5148-7643
authors.initials: V
authors.lastname: Romano
authors.affiliation: Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy.
authors.forename: Pietro
authors.identifier: 0000-0001-8491-6574
authors.initials: P
authors.lastname: Rosetta
authors.affiliation: Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Italy.
authors.forename: Emanuela F
authors.initials: EF
authors.lastname: Legrottaglie
authors.affiliation: Department and Clinic of Ophthalmology, Wrocław Medical University, 50-556 Wrocław, Poland.
authors.forename: Magdalena
authors.identifier: 0000-0001-6851-5527
authors.initials: M
authors.lastname: Kubrak-Kisza
authors.affiliation: Department of Surgical Sciences, Division of Ophthalmology, University of Insubria, 21100 Varese, Italy.
authors.forename: Claudio
authors.identifier: 0000-0002-1334-0974
authors.initials: C
authors.lastname: Azzolini
authors.affiliation: Department of Surgical Sciences, Division of Ophthalmology, University of Insubria, 21100 Varese, Italy; Department of Ophthalmology, Humanitas Mater Domini, Via Gerenzano 2, 21053 Castellanza, Italy.
authors.forename: Riccardo
authors.identifier: 0000-0002-2280-9981
authors.initials: R
authors.lastname: Vinciguerra
mesh_terms: D000328:Adult; D003315:Cornea / Q000000981:diagnostic imaging*; D042783:Endothelial Cells / Q000166:cytology; D005260:Female; D006801:Humans; D007478:Iontophoresis / Q000379:methods*; D007640:Keratoconus / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014787:Vision Tests; D055815:Young Adult