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CXL porte les promesses d'un traitement plus rapide (comparé aux semaines de traitements par collyres anti-microbiens), moins coûteux, avec une action à large spectre sans contrainte de résistances médicamenteuses ,
, Il est permis d'imaginer un futur proche où le traitement des kératites infectieuses pourrait être effectué dès le diagnostic précoce par des appareils portables de PACK-CXL
, Dans un contexte préoccupant de développement des résistances microbiennes aux antibiotiques et d'augmentation de l'incidence des kératites infectieuses, (favorisées par l'extension du port des lentilles de contact notamment dans les pays en développement), l'apparition de nouvelles lignes de traitement est suivie avec intérêt
, Le crosslinking a bouleversé la prise en charge du kératocône en offrant pour la première fois la possibilité de stopper l
, Peut-être s'agit-il des débuts d'une révolution de même ampleur dans l
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,
, But : évaluer et comparer la visibilité et la profondeur de la ligne de demarcation stromale par OCT de segment antérieur après cross-linking du collagène cornéen entre 2 groupes : CXL avec riboflavine hypo-osmolaire et iso-osmolaire. Design : étude retrospective Methode: les patients consécutifs ayant bénéficié d'un traitement par crosslinking accéléré, 10 minutes, 9mW/cm² ) pour kératocône progressif ont été inclus
, grade 1 = ligne visible mais non clairement définie, grade 2 = ligne visible, clairement définie. La profondeur de la ligne de demarcation était également mesurée. Resultats: 75 yeux de 58 patients, d'âge moyen 25,2 ans ± 9,1ont participé à l'étude. Le Kmax moyen pré-opératoire était de 57,4 D ± 5,4. La pachymétrie minimale moyenne était de 474,3 µm ± 35,7. La profondeur moyenne de la ligne de demarcation, évaluée par OCT 1 mois après la procédure était de 331,2 µm ± 62,7. Une ligne de demarcation était visible (grade 1 et 2) chez 54 (72%) des yeux traités, Une évaluation par OCT de segment antérieur (RS-3000, NIDEK) était réalisée 1 mois après l'intervention : la visibilité de la ligne de demarcation était cotée : grade 0 = ligne non vue, vol.82, p.0
, Conclusion: L'utilisation de riboflavine iso-osmolaire ou hypo-osmolaire pour la realization du crosslinking ne modifie pas significativement la visibilité ou la profondeur de la ligne de demarcation évaluée par OCT 1 mois après la procedure