The investigation of epithelial profile changes with OCT in keratoconus undergoing cross-linking

Abstract

Keratoconus (KCN) is a noninflammatory and billateraly asymmetric disease occuring during the second and third decades of life. The central or paracentral cornea undergoes progressive thinning and steepening causing irregular astigmatism.Videokeratography, including topography and pachymetry is important for screening of KCN. Generally, there are two approaches to treating keratoconus: slowing the progression of the disease and improving the vision. Mild to moderate keratoconus can be treated with eyeglasses or contact lenses. In progressive cases, corneal collagen cross-linking might be indicated to slow or stop the progression. Cross-linking stiffens the cornea to prevent further shape changes. In this procedure, the corneal epithelial thickness increases. The aim of this study is to investigate of epithelial profile changes in patients undergoing cross-linking. Method: Thirty eyes of 30 patients with keratoconus who were candidates for cross-linking were included. After cross-linking by Dresden method, patients underwent anterior segment OCT again with optovue device to examine the corneal epithelium . Results: The mean age of patients was 21.6 ± 4.1 years, of which 17 were female and 13 were male.The uncorrected visual acuity (UCVA) was 0.67 ± 0.18 before surgery and 0.59 ± 0.21 3 months after surgery(P value = 0.001).The best corrected visual acuity (BCVA) was 0.31 ± 0.05 before surgery and 0.19 ± 0.06 3 months after surgery (P value = 0.01). The superior corneal epithelial thickness was significantly reduced after surgery (55.2±3.8 and 52±3.58, befaore and after surgery, respectively, p value = 0.001). The inferotemporal corneal epithelial thickness was also significantly reduced after surgery (55.05±4.59 and 51.6±3.40, before and after surgery, respectively, p value = 0). The ratio of the superior /inferior corneal thickness was significantly reduced after surgery (1.02±0.069 and 0.966±0.031, before and after surgery, respectively, p value = 0.001).