Early outcomes favorable for epi-on CXL with iontophoresis

Chicago-Results from 1 year of follow-up show that transepithelial corneal crosslinking (CXL) with iontophoresis appears to be safe and effective in arresting the progression of keratoconus, said Paolo Vinciguerra, MD.

Dr. Vinciguerra presented outcomes data from 20 eyes of 20 patients-all with documented progressive ectatic disease-during Refractive Subspecialty Day here at the annual meeting of the American Academy of Ophthalmology. The treated patients were 18 years of age and older and were seen at serial visits at 1, 3, 6, and 12 months, said Dr. Vinciguerra, of the ophthalmology department, Istituto Clinico Huanitas Rozzano, Milan, Italy.

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Overall, the results showed significant improvement of best-corrected visual acuity accompanied by reductions in higher-order aberrations and average keratometry readings. Safety data showed that pachymetry measurements and endothelial cell counts were stable.

Complications included frequent epithelial defects and one case of epithelial burn.

“These results are promising in suggesting that transepithelial CXL with ionotphoresis has the potential to become a valid alternative for halting the progression of ectatic disease with benefits of reducing postoperative pain, infection risk, and treatment time compared with the standard epithelium-off technique,” Dr. Vinciguerra said. “However, we need longer follow-up. We have reported that a flattening effect is maintained at 5 years after epithelium-off CXL. Therefore, it will be important to wait for the results of the transepithelial iontophoresis procedure after 2, 3, 4, or more years.”