Management of Tomographically Suspicious Fellow Eyes of Young Patients With Unilateral Clinically Evident Keratoconus: Accelerated Epithelium-On Corneal Crosslinking Versus Observation

To investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone. This retrospective observational study included 43 fellow e...

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Vydané v:Cornea Ročník 44; číslo 12; s. 1480
Hlavní autori: Abdel-Radi, Mahmoud, Anwar, Mohamed, Aly, Momen Ahmad Mohammad, Eata, Wael El Shazly, Goda, Islam
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.12.2025
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Abstract To investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone. This retrospective observational study included 43 fellow eyes of 43 young patients with unilateral clinically evident KC who completed a 24-month follow-up. Twenty-four eyes underwent accelerated epithelium-on crosslinking [epi-on corneal crosslinking (CXL) group] and 19 eyes were observed (observation group). A third healthy control group was added for comparison. The primary outcome measures were tomographic parameters and topometric indices assessed by pentacam. Secondary outcome measures included corneal ectatic progression defined as 1-diopter or more increase in maximum or steep keratometry (K max or K 2 ), visual & refractive outcomes, and complications. Baseline demographic and tomographic characteristics were similar between the epi-on CXL and observation groups ( P > 0.05). Almost all mean tomographic parameters and topometric indices showed insignificant differences between baseline and after 24 months in the epi-on CXL and control groups ( P > 0.05), whereas a significant progression was documented in the observation group ( P < 0.05). At the end of the follow-up, progression was documented in 1 eye (4.2%) and in 8 eyes (42.1%) in the epi-on CXL and observation groups, respectively. Visual and refractive outcomes were more favorable in the epi-on CXL group. No significant complications were reported after accelerated epi-on CXL. Accelerated epithelium-on CXL was safe and achieved better tomographic stability and less corneal ectatic progression in tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus compared with observation alone.
AbstractList To investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone. This retrospective observational study included 43 fellow eyes of 43 young patients with unilateral clinically evident KC who completed a 24-month follow-up. Twenty-four eyes underwent accelerated epithelium-on crosslinking [epi-on corneal crosslinking (CXL) group] and 19 eyes were observed (observation group). A third healthy control group was added for comparison. The primary outcome measures were tomographic parameters and topometric indices assessed by pentacam. Secondary outcome measures included corneal ectatic progression defined as 1-diopter or more increase in maximum or steep keratometry (K max or K 2 ), visual & refractive outcomes, and complications. Baseline demographic and tomographic characteristics were similar between the epi-on CXL and observation groups ( P > 0.05). Almost all mean tomographic parameters and topometric indices showed insignificant differences between baseline and after 24 months in the epi-on CXL and control groups ( P > 0.05), whereas a significant progression was documented in the observation group ( P < 0.05). At the end of the follow-up, progression was documented in 1 eye (4.2%) and in 8 eyes (42.1%) in the epi-on CXL and observation groups, respectively. Visual and refractive outcomes were more favorable in the epi-on CXL group. No significant complications were reported after accelerated epi-on CXL. Accelerated epithelium-on CXL was safe and achieved better tomographic stability and less corneal ectatic progression in tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus compared with observation alone.
To investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone.PURPOSETo investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone.This retrospective observational study included 43 fellow eyes of 43 young patients with unilateral clinically evident KC who completed a 24-month follow-up. Twenty-four eyes underwent accelerated epithelium-on crosslinking [epi-on corneal crosslinking (CXL) group] and 19 eyes were observed (observation group). A third healthy control group was added for comparison. The primary outcome measures were tomographic parameters and topometric indices assessed by pentacam. Secondary outcome measures included corneal ectatic progression defined as 1-diopter or more increase in maximum or steep keratometry (Kmax or K2), visual & refractive outcomes, and complications.METHODSThis retrospective observational study included 43 fellow eyes of 43 young patients with unilateral clinically evident KC who completed a 24-month follow-up. Twenty-four eyes underwent accelerated epithelium-on crosslinking [epi-on corneal crosslinking (CXL) group] and 19 eyes were observed (observation group). A third healthy control group was added for comparison. The primary outcome measures were tomographic parameters and topometric indices assessed by pentacam. Secondary outcome measures included corneal ectatic progression defined as 1-diopter or more increase in maximum or steep keratometry (Kmax or K2), visual & refractive outcomes, and complications.Baseline demographic and tomographic characteristics were similar between the epi-on CXL and observation groups (P > 0.05). Almost all mean tomographic parameters and topometric indices showed insignificant differences between baseline and after 24 months in the epi-on CXL and control groups (P > 0.05), whereas a significant progression was documented in the observation group (P < 0.05). At the end of the follow-up, progression was documented in 1 eye (4.2%) and in 8 eyes (42.1%) in the epi-on CXL and observation groups, respectively. Visual and refractive outcomes were more favorable in the epi-on CXL group. No significant complications were reported after accelerated epi-on CXL.RESULTSBaseline demographic and tomographic characteristics were similar between the epi-on CXL and observation groups (P > 0.05). Almost all mean tomographic parameters and topometric indices showed insignificant differences between baseline and after 24 months in the epi-on CXL and control groups (P > 0.05), whereas a significant progression was documented in the observation group (P < 0.05). At the end of the follow-up, progression was documented in 1 eye (4.2%) and in 8 eyes (42.1%) in the epi-on CXL and observation groups, respectively. Visual and refractive outcomes were more favorable in the epi-on CXL group. No significant complications were reported after accelerated epi-on CXL.Accelerated epithelium-on CXL was safe and achieved better tomographic stability and less corneal ectatic progression in tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus compared with observation alone.CONCLUSIONSAccelerated epithelium-on CXL was safe and achieved better tomographic stability and less corneal ectatic progression in tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus compared with observation alone.
Author Eata, Wael El Shazly
Abdel-Radi, Mahmoud
Anwar, Mohamed
Aly, Momen Ahmad Mohammad
Goda, Islam
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Issue 12
Keywords epi-on CXL
accelerated crosslinking
asymmetric ectasia
unilateral keratoconus
subclinical keratoconus
Language English
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SubjectTerms Adolescent
Adult
Collagen - metabolism
Corneal Stroma - metabolism
Corneal Topography
Cross-Linking Reagents - therapeutic use
Epithelium, Corneal
Female
Follow-Up Studies
Humans
Keratoconus - diagnosis
Keratoconus - drug therapy
Keratoconus - metabolism
Keratoconus - physiopathology
Male
Photochemotherapy - methods
Photosensitizing Agents - therapeutic use
Refraction, Ocular - physiology
Retrospective Studies
Riboflavin - therapeutic use
Ultraviolet Rays
Visual Acuity - physiology
Young Adult
Title Management of Tomographically Suspicious Fellow Eyes of Young Patients With Unilateral Clinically Evident Keratoconus: Accelerated Epithelium-On Corneal Crosslinking Versus Observation
URI https://www.ncbi.nlm.nih.gov/pubmed/39774276
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