Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results

Purpose: To assess ultrastructural corneal changes induced by oxygen boost transepithelial crosslinking (OBXL) and its efficacy at 2 years. Methods: This pilot cohort study was conducted at the French National Reference Keratoconus Center in patients with progressive keratoconus. Corneal transepithe...

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Main Authors: Valentine Saunier, Pierre Legout, Nathalie Thiery, Pierre Fournie, David Touboul
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:JFO Open Ophthalmology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949889924000771
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author Valentine Saunier
Pierre Legout
Nathalie Thiery
Pierre Fournie
David Touboul
author_facet Valentine Saunier
Pierre Legout
Nathalie Thiery
Pierre Fournie
David Touboul
author_sort Valentine Saunier
collection DOAJ
description Purpose: To assess ultrastructural corneal changes induced by oxygen boost transepithelial crosslinking (OBXL) and its efficacy at 2 years. Methods: This pilot cohort study was conducted at the French National Reference Keratoconus Center in patients with progressive keratoconus. Corneal transepithelial CXL with an additional source of oxygen delivered through the goggles was performed. All patients who underwent surgery had an evaluation preoperatively, between 1 and 3 mo postoperatively, and at 6, 12 and 24 mo postoperatively.Biomechanical (Corvis ST), topographical (CASIA-2), and microstructural changes (using In Vivo Confocal Microscopy and Anterior Segment OCT) following this new technique were assessed. We also evaluated visual acuity and eye rubbing behavior. Results: Ten eyes of ten patients were enrolled, with a mean age of 23.8 ± 4.9 years. A visible demarcation line was observed on AS-OCT with a mean depth of 414 μm ± 80.91 (89 % of the total thickness). We also noticed an anterior hyperreflective band with a mean depth of 214 ± 42.95 μm. At 6, 12 and 24 mo postoperatively, the Kmax, Kmin, Cyl and Corneal Thinnest Point were stable (p > 0.05). At 24 mo, there was significant improvement in BCVA. Compared to baseline, at the first postoperative visit, corneal sub-basal nerve density decreased, and keratocyte apoptosis was observed in all patients. Regarding eye rubbing, the number of patients who rubbed their eyes frequently decreased after CXL. Conclusion: This study confirmed the histological effects of OBXL and a deep corneal interaction that is effective in stabilizing keratoconus.
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spelling doaj-art-4b73d1a324a64ab8991eca9416fa1bb52025-08-20T03:15:16ZengElsevierJFO Open Ophthalmology2949-88992025-03-01910015310.1016/j.jfop.2024.100153Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural resultsValentine Saunier0Pierre Legout1Nathalie Thiery2Pierre Fournie3David Touboul4National Center for Keratoconus, CHU Bordeaux, France; Corresponding author.National Center for Keratoconus, CHU Bordeaux, FranceNational Center for Keratoconus, CHU Bordeaux, FranceNational Center for Keratoconus, CHU Toulouse, FranceNational Center for Keratoconus, CHU Bordeaux, FrancePurpose: To assess ultrastructural corneal changes induced by oxygen boost transepithelial crosslinking (OBXL) and its efficacy at 2 years. Methods: This pilot cohort study was conducted at the French National Reference Keratoconus Center in patients with progressive keratoconus. Corneal transepithelial CXL with an additional source of oxygen delivered through the goggles was performed. All patients who underwent surgery had an evaluation preoperatively, between 1 and 3 mo postoperatively, and at 6, 12 and 24 mo postoperatively.Biomechanical (Corvis ST), topographical (CASIA-2), and microstructural changes (using In Vivo Confocal Microscopy and Anterior Segment OCT) following this new technique were assessed. We also evaluated visual acuity and eye rubbing behavior. Results: Ten eyes of ten patients were enrolled, with a mean age of 23.8 ± 4.9 years. A visible demarcation line was observed on AS-OCT with a mean depth of 414 μm ± 80.91 (89 % of the total thickness). We also noticed an anterior hyperreflective band with a mean depth of 214 ± 42.95 μm. At 6, 12 and 24 mo postoperatively, the Kmax, Kmin, Cyl and Corneal Thinnest Point were stable (p > 0.05). At 24 mo, there was significant improvement in BCVA. Compared to baseline, at the first postoperative visit, corneal sub-basal nerve density decreased, and keratocyte apoptosis was observed in all patients. Regarding eye rubbing, the number of patients who rubbed their eyes frequently decreased after CXL. Conclusion: This study confirmed the histological effects of OBXL and a deep corneal interaction that is effective in stabilizing keratoconus.http://www.sciencedirect.com/science/article/pii/S2949889924000771CorneaKeratoconusCorneal collagen crosslinkingIn Vivo Confocal MicroscopyCorneal innervation
spellingShingle Valentine Saunier
Pierre Legout
Nathalie Thiery
Pierre Fournie
David Touboul
Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
JFO Open Ophthalmology
Cornea
Keratoconus
Corneal collagen crosslinking
In Vivo Confocal Microscopy
Corneal innervation
title Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
title_full Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
title_fullStr Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
title_full_unstemmed Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
title_short Oxygen boost transepithelial corneal collagen crosslinking: 2-year ultrastructural results
title_sort oxygen boost transepithelial corneal collagen crosslinking 2 year ultrastructural results
topic Cornea
Keratoconus
Corneal collagen crosslinking
In Vivo Confocal Microscopy
Corneal innervation
url http://www.sciencedirect.com/science/article/pii/S2949889924000771
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AT nathaliethiery oxygenboosttransepithelialcornealcollagencrosslinking2yearultrastructuralresults
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