Photorefractive intrastromal corneal crosslinking for treatment of low myopia: Clinical outcomes using the transepithelial approach with supplemental oxygen

Abstract

Purpose:To evaluate the safety and efficacy of photorefractive intrastromal corneal crosslinking (PiXL) for the treatment of low myopia using the epithelium-on approach with supplemental oxygen.Setting:The Eye Foundation, Coimbatore, India.Design:Prospective interventional case series.Methods:Myopic nonectatic eyes underwent PiXL using the Mosaic system. Ultraviolet-A (UV-A) irradiation of 365 nm wavelength was delivered in an accelerated (30 mW/cm2) pulsed approach to provide a total fluence of 15 J/cm2. Supplemental oxygen (concentration greater than 95%) was provided to increase the efficacy of the epithelium-on approach during the UV-A irradiation. Efficacy was determined by improvement in mean refractive spherical equivalent (MRSE), uncorrected distance visual acuity (UDVA), and keratometric flattening. Safety was determined by loss of lines of corrected distance visual acuity, endothelial cell loss, and adverse events.Results:Fifty eyes of 26 patients with a mean age of 22.73 ± 3.74 years were included. A significant improvement in UDVA from baseline (logarithm of the minimum angle of resolution [logMAR] 0.63 ± 0.25) was noted at the 3-month (logMAR 0.08 ± 0.15) and 6-month (logMAR 0.13 ± 0.18) follow-up visits (P