Five Years Results Of Iontophoresis-Assisted Transepithelial Corneal Cross-Linking For Keratoconus.

To assess long term efficacy and safety of Iontophoresis assisted transepithelial Corneal Cross Linking (CXL) for keratoconus.

Ophthalmology Unit, Department of Surgery, University Hospital of Messina, Messina, Italy

Twenty-one patients (15 males, 6 females, mean age 25.7 ± 2.8 years) with progressive keratoconus were treated with Iontophoresis-assisted transepithelial CXL. All patients were examined at baseline and after 1, 3, 6,12 months and successively every 6 months for 5 years after the procedure. The main outcome measures were uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), corneal transparency and corneal parameters such as Kmax, central corneal thickness (CCT) at the thinnest point, and high order ocular aberrations (HOAs). The baseline and 5 years data were considered for evaluation.

At 5 years there was a significant change of UCVA from 0.53 ± 0.33 LogMAR to 0.4 ± 0.33 LogMAR (p=0.01). Non-significant changes of CDVA (p=0.39), Kmax (p=0.91), CCT (p=0.75), and HOAs (p= 0.35) were observed at the end of follow-up period. Furthermore, no adverse events, including corneal opacities and progression of ectasia were reported. All treated eyes were stable at 5 years after treatment.

Iontophoresis-assisted transepithelial CXL resulted as a safe and effective procedure to halt keratoconus progression and stability during a 5 years observational period.