Pachymetric changes during corneal collagen cross-linking and

effect of hydroxipropylmethylcellulose on

corneal thickness

Faik Oruçoğlu(Orucov)

Kudret Eye Hospital / Istanbul

Purpose

To evaluate central corneal pachymetric changes during corneal collagen cross-linking (CXL) and effect of hydroxipropylmethylcellulose (HPMC) drops.

Hydroxipropylmethylcellulose

Hypromellose• Hydrophylic• pH: 7,2-7,9• Osmolarity 240-300 mOsm

Spoerl E,.Safety of UVA-riboflavin cross-linking of the cornea. Cornea 2007;26:385–9

Ophthalmology 2009; 116(12) 2336-9

Methods

Grup 1. (N=18). • Epithelial abrasion (9mm)• 0.1 % Riboflavin drops in dextrane every 3 minutes for 30 minutes. • UVA 3mw/cm2 at 365nm for 30 min

Grup 2. (N=21). • Epithelial abrasion (9mm)• 0.1 % Riboflavin drops in dextrane every 3 minutes and

hydroxipropylmethylcellulose (HPMC) every 5 minutes for 30 minutes. • UVA 3mw/cm2 at 365nm for 30 min

Two groups were formed in patients with keratoconus undergoing cross-linking ;

Central corneal thicknesses were measured by ultrasound pachimetry

– before epithelial abrasion, – after epithelial abrasion and – 30 minutes after beginning riboflavin installation

Before epithelial abrasion After epithelial abrasion P

Grup 1 457.2 + 62.6 395±54,9 <0,001

Grup 2 449.7 + 62.6 389,4±44,2 0,009

After epithelial abrasion 30 minutes after riboflavin installation

P

Grup 1 395±54,9 360±44,4 <0,001

Grup 2 389,4±44,2 374,4±38,1 0,08

450

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Group 1

Group 2

After epithelial abrasion 30 minutes after riboflavin

Conclusion Decrease of corneal thickness continues with

epithelial peeling. This decrease in corneal thickness is significantly reduced by continuing the procedure with the addition of HPMC.

Rb+Dextran H2O Rb+Dextran H2OHPMC

Thank you for your attention