Short-term comparison of accelerated and standard methods of corneal collagen crosslinking

J Cataract Refract Surg. 2015 Mar;41(3):533-40. doi: 10.1016/j.jcrs.2014.07.030.

Abstract

Purpose: To compare the 6-month results of accelerated and standard collagen crosslinking (CXL) treatment of progressive keratoconus.

Setting: Noor Eye Hospital, Tehran, Iran.

Design: Prospective randomized clinical trial.

Methods: Two groups of eyes (intervention and control) received corneal collagen crosslinking (CXL) treatment. The intervention group received accelerated CXL (18 mW/cm(2), 5 minutes), and the control group received standard CXL (3 mW/cm(2), 30 minutes). The eyes were evaluated for changes in the visual indices, refraction, and topography preoperatively and 1, 3, and 6 months postoperatively and regarding corneal rigidity indices and the endothelial cell count (ECC) preoperatively and at 6 months.

Results: The study evaluated 62 eyes (31 patient) in 2 groups. The mean changes in uncorrected (P = .733) and corrected (P = .646) distance visual acuities and manifest refraction spherical equivalent (P = .598) did not differ statistically significantly between the 2 groups. The central corneal thickness was higher in the standard group than the accelerated group (P = .025). The mean decrease in the maximum keratometry (K) (P = .865) and mean K (P = .974) and the mean changes in the asphericity (P = .272) were not statistically significantly different between the 2 groups. The mean changes in corneal hysteresis (CH) (P = .548) and the corneal resistance factor (CRF) (P = 1.000), CH-CRF (P = .282), and the area under the peak 2 (P = .260) were similar in both groups. The mean decrease in the ECC was not statistically significantly different between the 2 groups (P = .218).

Conclusion: Based on 6-month results, accelerated and standard corneal CXL arrested the progression of keratoconus similarly.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Collagen / metabolism*
  • Corneal Stroma / metabolism*
  • Cross-Linking Reagents*
  • Female
  • Humans
  • Keratoconus / drug therapy*
  • Keratoconus / metabolism
  • Keratoconus / physiopathology
  • Male
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Riboflavin / therapeutic use
  • Ultraviolet Rays
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin