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EFFECT OF ACCELERATED CORNEAL COLLAGEN CROSS-LINKING ON KERATOCONUS ENDOTHELIUM CELLS
*Hala Konz AlHaji, Taym Darwish and Kahtan Jalloul
Purpose: Evaluating the safety of Accelerated Corneal Collagen Cross-Linking on Keratoconus Endothelium cells. Methods: In this prospective study, (50) eyes of (27) progressive Keratoconus patients underwent Accelerated Corneal Collagen Cross-Linking (ACXL), (15) Epithelium-off (Epi-off) and (12) Epithelium-on (Epi-on) in the Ophthalmology Department in Tishreen University Hospital. Endothelial specular microscopy was performed on (50) eyes before, after 1, 3, and 6 months of ACXL. Studied parameters included endothelial cell density (ECD), coefficient of variation (CV) in cell area, percentage of hexagonality (EX) and corneal thickness. Results: Mean endothelial cell densities before and after six months of ACXL were 2702.6±242.2 and 2697.8±280.2, respectively (p= 0.4). Mean coefficient of variation before and after ACXL were 29.3±4.3 and 28.8±4.08 respectively (p= 0.09). Mean percentage of hexagonal cells before and after ACXL were 59.9±7.06 and 58.5±7.6 (p= 0.09), respectively. By comparing the changes of the endothelial cell parameters between the two ACXL groups, the intensity at the end of the follow-up in the Epi-off and Epi-on groups were (2781.5 ± 250.8 and 2702.8 ± 317.2), respectively (p = 0.3). The coefficient of cell volume at the end of follow-up in the Epi-off and Epi-on groups, was (29.4 ± 4.1 and 28.4 ± 4.2), respectively (p = 0.4). Average percentage of hexagonal cells at the end of follow-up in the Epi-off and Epi-on groups (57.08 ± 9.4 and 61.6 ± 5.5), respectively (p = 0.6). Corneal thickness at the end of follow-up in the Epi-off and Epi-on groups (462.2 ± 46.5 and 454.9 ± 41.7) respectively (p = 0.2). Conclusion: Accelerated Corneal Collagen Cross-Linking, including Epi-off and Epi-on, doesn't have a significant effect on corneal endothelial cells density or morphology in this study. Transient changes, that are statistically insignificant in both types, are less valuable in Epi-on ACXL.[Full Text Article]