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Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Safety and efficacy of photorefractive intrastromal cross-linking (PiXL) for the treatment of low myopia using epithelium-on approach with supplemental oxygen

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Session Details

Session Title: Presented Poster Session: Cross-Linking

Venue: Poster Village: Pod 2

First Author: : G.Sachdev INDIA

Co Author(s): :    S. Ramamurthy                       

Abstract Details


To evaluate the safety and efficacy of Photorefractive Intrastromal Cross-linking (PiXL) for the treatment of low myopia using epithelium-on approach with supplemental oxygen. To evaluate the treatment parameters impacting the efficacy of treatment in reduction of myopic refractive error.


Refractive Services, The Eye Foundation, Coimbatore – A tertiary eye care hospital in South India


PiXL was performed in 58 eyes of patients seeking refractive correction unwilling for laser vision correction.Crosslinking was performed using the Mosaic system with the accelerated epithelium on approach. Supplemental oxygen was provided additionally to increase the efficacy of the transepithelial approach. The efficacy was determined by the mean change in manifest refraction spherical equivalent (MRSE), uncorrected distance visual acuity (UDVA) and corneal curvature (mean, flat and steep keratometry) from baseline. Safety was demonstrated by endothelial cell loss (specular microscopy) and visually significant corneal haze. Patients were followed up for a minimum period of 6 months.


The mean change in MRSE from baseline was 1.18 +/-0.5D at 3 months with a change in UDVA of Log MAR 0.526 (P<0.05). The mean change in keratometry was 1.67 +/- 1.2 D (P<0.05). No significant regression or hyperopic shift was noted during the six-month follow-up period. 73.8% of the eyes demonstrated an uncorrected distance visual acuity of 20/25 or better at six-months follow-up visit. No significant endothelial cell count or loss of best corrected visual acuity due to corneal haze was noted. The mean satisfaction score was 4.3 (out of 5).


The epithelium on protocol with supplemental oxygen showed reduction in myopic refractive error utilizing PiXL. Our protocol demonstrated superior keratometric flattening and refractive outcomes in comparison to the earlier published data utilizing both epithelium-on approach (without oxygen) as well as the epithelium-off approach.

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