Dry Eye Parameters after CXL

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1 Augenklinik am Augenabteilung St. Franziskus am Hospital St. Franziskus Münster Hospital Münster Dry Eye Parameters after CXL Suphi Taneri, Saskia Oehler, John A. Kanellopoulos 2nd International Congress for Advanced Corneal Cross-Linking, September 7, 213, Rome Cavalieri, Italy Purpose To evaluate a potential influence of CXL in keratoconic eyes on several parameters of dry eye syndrome. Article in press 1

2 Methods Prospective single center study Including 3 consecutive eyes of 16 patients Treatment: CXL with riboflavin and UV-A treatment: epithelial removal 3 min soaking with riboflavin 3 min illumination with 36 nm 3 mw/cm 2, cm distance Measurements Preoperatively, and 3 and 6 months after crosslinking, intraindividual comparison of the following parameters: fluorescein staining (normal or pathologic; pathologic: more than 1 point-shaped of diffuse staining areas) rose Bengal staining using the van Bijsterfeld-Index height of tear film meniscus tear-film break-up-time (<s, -1s, >1s) signs of dry eye at slit-lamp exam subjective symptoms (qualitative score: better, unchanged, worse) 2

3 Fluorescein Staining eyes pathologic normal One eye (3.3%) showed pathologic staining with fluorescein before CXL. One other eye 3 months after CXL, yet another eye 6 months after CXL, respectively. Differences were not statistically significant. Rose Bengal Staining Van-Bijsterfeld-Index (-9) Rose Bengal staining 3 and 6 months postoperatively was comparable to preoperative staining. Differences were not statistically significant. 3

4 Break-up time 3 number of eyes <s -1s >1s The number of eyes with reduced tear-film break-up-time was not significantly changed after 3 and 6 months. Height of tear-film meniscus 3 number of eyes Height of tear-film meniscus normal reduced increased Tear-film height was reduced in more eyes after 3 months than before CXL. Tear-film height was normal in all eyes after 6 months 4

5 Subjective evaluation eyes better worse 3 months postop 6 months postop Three months after CXL, 31% of eyes reported worse, and 21% of eyes reported improved subjective evaluations compared to preoperative evaluations. After 6 months, 7% of eyes reported worse, and 2% of eyes reported improved evaluations (figure 6). Differences were not statistically significant. Conclusion We found no significant impact of CXL on several parameters of dry eye syndrome at 3 and 6 months postoperatively. However, different CXL protocols may lead to a stronger influence. This study did not examine early postoperative changes.

6 Discussion Histologic recovery of corneal nerves after LASIK lasts up to 1 year. In contrast, using confocal microscopy after CXL, Kymionis et al. found that the subepithelial nerve plexus was absent immediately after treatment but regeneration of nerves was evident after the third postoperative month. This may be the anatomical explanation of our results. Thank you! Augenabteilung am St. Franziskus Hospital Münster 6

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