International Journal of Keratoconus and Ectatic Corneal Diseases

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VOLUME 7 , ISSUE 2 ( July-December, 2018 ) > List of Articles

Original Article

Epithelium-on Corneal Cross-linking for Progressive Keratoconus: Two-year Outcomes

Arthur B Cummings, Parker J Shaw, Gabrielle Kelly

Keywords : Accelerated corneal cross-linking, Blurred vision, Corneal cross-linking, Corneal ectasia, Corneal tomography, Corneal topography, Corneal transplant, Eye rubbing, Femtosecond- laser assisted DALK, Keratoconus, Steep corneas, Quality of vision, Vogt's striae

Citation Information : Cummings AB, Shaw PJ, Kelly G. Epithelium-on Corneal Cross-linking for Progressive Keratoconus: Two-year Outcomes. Int J Kerat Ect Cor Dis 2018; 7 (2):110-114.

DOI: 10.5005/jp-journals-10025-1166

License: CC BY-NC 4.0

Published Online: 01-12-2012

Copyright Statement:  Copyright © 2018; The Author(s).


Corneal cross-linking (CXL) has been established as a successful treatment tool for the treatment of progressive keratoconus in terms of slowing or halting progressive corneal steepening and thinning and even on some occasions, reversing the steepening. To date the Dresden epithelium-off protocol is regarded as the gold standard and the epithelium-on (epi-on) approaches have met with less success. Both doctors and patients would welcome an epi-on CXL procedure that provided good outcomes as the morbidity with epi-on CXL is so much less and the safety is enhanced. Patient comfort is greater with the epi-on techniques when compared to epi-off. This study looked at 82 eyes that had documented progression of keratoconus and then underwent epi-on CXL using the CXLO system. The results show that corneal steepening can be halted and even reversed over a 2-year follow-up period with no complications noted. Over the 24 months post treatment on average there was a decrease in all keratometry values, BAD and ISV when compared to before treatment with IHD being marginally increased. Further studies over a longer follow-up period are required but recent publications using the same approach are validating the findings seen in this study.

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