Corneal collagen cross linking (CXL) in treatment of pseudophakic bullous keratopathy

Abstract

Objective: To determine mean change in visual acuity, central corneal thickness and symptoms in patients with pseudophakic bullous keratopathy after treatment with corneal collagen crosslinking. Methods: This quasi experimental study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from April 2015 to Nov 2015. A total of 24 eyes of 24 patients were included in the study. Visual symptoms were graded in five grades (Grade 1-5), Grade-1 being very mild with decreased vision only while patients with all five symptoms (decreased vision, foreign body sensations, pain, watering and photophobia) were graded as Grade-5. Corneal collagen cross linking using topical isotonic riboflavin followed by UVA radiations (3mW/cm2for 10 minutes) was performed in all the patients. Visual acuity (VA), visual symptoms and central corneal thickness (CCT) were recorded before and 04 weeks after the treatment. Results: A total of 24 eyes of 24 patients (18 male and 6 females) underwent surgery. Age of the patients ranged from 55 to 75 years with mean age 65.83 + 3.89 years. Mean visual acuity was 2.09 + 0.23 before treatment while after treatment it was 2.13 + 0.22. Mean CCT as measured by optical pachymetry (Galilae G6) was 753.96 + 55.16 and 641+ 29.25 before and after surgery respectively. Improvement of clinical symptoms was seen in all the patients. Conclusion: Corneal collagen cross linking is a temporary but effective symptomatic treatment of pseudophakic bullous keratopathy.