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Thermographic analysis of the corneal surface in epi-on and epi-off corneal crosslinking for keratoconus
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.ORCID iD: 0000-0002-8456-8036
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.ORCID iD: 0000-0002-1855-3207
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
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2024 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 102, no 5, p. 529-534Article in journal (Refereed) Published
Abstract [en]

Purpose: To analyse the temperature of the corneal surface in keratoconus during corneal customized crosslinking (CXL) with a preserved epithelium (epi-on) under oxygen flow, and epi-off CXL in room air, and to assess the effect of pre-heating the oxygen.

Methods: This masked, intra-individual comparing randomized study included 14 participants with bilateral progressive keratoconus treated with bilateral CXL: one eye with epi-on CXL under a flow of 2.5 L/min oxygen; the fellow eye with epi-off CXL in room air. In a second setting involving 12 healthy participants, room-tempered oxygen was flushed over one eye and oxygen pre-heated to 37°C over the fellow eye. The corneal surface temperature was assessed with infrared photography.

Results: A reduction in corneal surface temperature was seen from the pre-treatment application of topical riboflavin in the epi-off group (−1.1 ± 1.0°C, p < 0.001). The temperature increased during the first half of the CXL treatment in both groups (+0.7 ± 1.2°C, p = 0.041 for epi-on; +0.7 ± 0.9°C, p = 0.023 for epi-off CXL, respectively). In epi-on CXL an overall temperature increase was seen during the treatment (+0.8 ± 1.2°C, p = 0.016). In the second setting, pre-heating the oxygen rendered a surface temperature increase of +1.8 ± 0.2°C (p < 0.001).

Conclusion: In epi-off CXL, the application of topical room-tempered riboflavin decreases the corneal surface temperature, likely due to increased evaporation. A slight temperature increase is seen during CXL with both epi-on and epi-off CXL, albeit far below the corneal safety limit. The corneal temperature can, however, be increased by applying pre-heated oxygen, a possible approach to modify or augment the treatment effect in CXL.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 102, no 5, p. 529-534
Keywords [en]
crosslinking, keratoconus, oxygen, temperature
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:umu:diva-217440DOI: 10.1111/aos.15817ISI: 001107369600001PubMedID: 37983864Scopus ID: 2-s2.0-85177474226OAI: oai:DiVA.org:umu-217440DiVA, id: diva2:1816558
Available from: 2023-12-04 Created: 2023-12-04 Last updated: 2024-08-07Bibliographically approved

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Fredriksson, AnneliNäslund, SofieViberg, AndreasBehndig, Anders

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CiteExportLink to record
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