Therapeutic possibilities for secondary epithelial-endothelial corneal dystrophy using a portable device for local collagen crosslinking

Abstract

Purpose: to evaluate the effectiveness of corneal collagen crosslinking (CCC) with a portable Keratolink device in patients with bullous keratopathy after cataract surgery.Materials and methods. 19 patients (19 eyes) aged 60 to 87 with secondary epithelial-endothelial corneal dystrophy, developed due to cataract surgery received three CCC procedures which lasted 20 minutes each, with intervals of 2 days between the procedures.Results. The mean corneal pain score according to verbal pain scale decreased to 4.5 from the initial 9 points and did not change significantly at subsequent visits. Optical coherence tomography data show that before the first procedure, the average corneal transparency score was 2.8 while by the 20th day of observation it fell to 1.4 points. After 3 CCC procedures, bullae continued to form in 3 patients only (3 eyes, 16 %) over the entire 3-month-long observation period. The best corrected visual acuity 3 months after CСC in patients was about 0.07 ± 0.02, which is slightly higher than the initial value (0.05 ± 0.03).Conclusion. A short course of ultraviolet CCC with a portable Keratolink device may be recommended as a palliative treatment for elderly patients with bullous keratopathy developed after cataract surgery.

Keywords

• secondary epithelial-endothelial corneal dystrophy
• bullous keratopathy
• corneal collagen crosslinking
• keratolink