New technique shows promise

An emerging technique has shown promise in the treatment of progressive keratoconus.

University of Tokyo researchers evaluated the clinical results of treating progressive keratoconus patients with accelerated transepithelial corneal crosslinking.

They found that the technique had several advantages over the conventional procedure, which involves epithelial removal.

Dr Wei Aixinjueluo, from the University of Tokyo’s Department of Ophthalmology, told OT  that the clinical results illustrated the technique was safe and effective for the treatment of progressive keratoconus.

Researchers observed faster recovery times, a reduced rate of complications and less operative and post-operative discomfort when compared with epithelial removal, he said.

Accelerated transepithelial corneal crosslinking was also significantly quicker than the standard technique, with a treatment time of only a few minutes compared with an hour for the standard procedure.

Dr Aixinjueluo highlighted that the technique was particularly useful for patients who were sensitive to the long operative time and possible effects of epithelial removal in the standard procedure, as well as patients with a corneal thickness of less than 400mm.

For patients with a cornea thinner than this measurement, the standard procedure could not be used without serious risks to the endothelium.

The study, published in the British Journal of Ophthalmology, involved accelerated transepithelial corneal crosslinking being performed on 30 patients with progressive keratoconus.

Researchers recorded uncorrected visual acuity, best corrected visual acuity, average keratometry, maximum keratometry, central corneal thickness, thinnest corneal thickness and endothelial cell density regularly from one week to 12-months after the operation.

“After 12 months, there was a significant improvement in maximum keratometry, average keratometry and best corrected visual acuity,” Dr Aixinjueluo emphasised.

The limitations of the study were the small sample size, the short follow up period and the lack of a control group, Dr Aixinjueluo explained.

Research involving a longer follow up with a larger group of patients, including a control group, was needed to assess the long-term results of the technique, he said.