الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Specular microscopy can provide a non-invasive morphological analysis of the corneal endothelial cell layer. The analysis provides a measure of the endothelial cell physiology reserve from aging, ocular surgical procedures, pharmaceutical exposure, and general health of the corneal endothelium. The physiology of corneal healing, time course of clinical changes and ultimate clinical outcomes of CXL for the treatment of keratoconus continue to be elucidated.
Corneal cross-linking is nowadays the most used strategy for the treatment of keratoconus and recently it has been exploited for many corneal pathologies; from ectatic disorders to keratitis. The safety of this technique has been widely assessed, but clinical complications still occur.
Performing cross-linking with epi-off technique provided good results in stabilization of KC in a group of 30 eyes followed up for 6 months, because we did not find statistically significant differences in corneal parameters (cct, cd, cv, hex) before and after CXL procedure. Our results are consistent with other studies published with a similar technique and a similar period of follow-up. Both experimen¬tal and clinical results have shown more CXL effect using an epi-off technique. The evidence so far is that epi-off CXL remains the most effective method of strengthening the cornea and slowing KC progression.
In conclusion
The main purpose of this study was to assess the safety of CXL with epithelium removal for the treatment of progressive KC patients on the corneal endothelium by endothelial specular microscopy comparing corneal parameters (cct, cv, cd, hex) and we did not find statistically significant differences in corneal parameters before and after the CXL procedure.
So epi-off CXL method has been firmly established to be safe on corneal endothelium, effective and the global standard of care for the treatment of progressive keratoconus.