<p>Transepithelial accelerated versus conventional corneal collagen crosslinking in patients with keratoconus: a comparative study</p>

Abstract

Purpose To systematically compare the efficacy of transepithelial accelerated corneal collagen crosslinking (TE-ACXL) with conventional corneal collagen crosslinking (C-CXL) in patients with progressive keratoconus. Methods Eyes of patients with progressive keratoconus who were treated with C-CXL (3 mW/cm 2 for 30 minutes) were compared with those who underwent TE-ACXL (6 mW/cm 2 for 15 minutes). Best-corrected visual acuity (BCVA), keratometry values, corneal thickness, and topometric indexes were compared before CXL, and at 2 months, 6 months, and 12 months postoperatively. Results The study enrolled 26 eyes of which 16 had TE-ACXL and 10 had C-CXL. Both groups were comparable at baseline and 12 months in terms of BCVA ( P =0.16 and P =0.57), Kmax (maximum keratometry) ( P =0.31 and P =0.73), pachymetry ( P =0.75 and P =0.37), index of surface variance (ISV) ( P =0.45 and P =0.86), index of vertical asymmetry (IVA) ( P =0.26 and P =0.61), and index of height decentration (IHD) ( P =0.27 and P =0.86, respectively). We did not observe significant differences between preoperative and 12-month postoperative readings in within-group analysis: ΔKmax (TE-ACXL, −2.13±5.41, P =0.25 vs C-CXL, 0.78±1.65, P =0.17), Δpachymetry (TE-ACXL, 4.10±14.83, P =0.41 vs C-CXL, −8.90±22.09, P =0.24), ΔISV (TE-ACXL, −8.50±21.26, P =0.24 vs C-CXL, 3.80±12.43, P =0.36), ΔIVA (TE-ACXL, −0.12±0.31, P =0.26 vs C-CXL, 0.03±0.18, P =0.61), and ΔIHD (TE-ACXL, −0.03±0.07, P =0.18 vs C-CXL, −0.01±0.03, P =0.88). Conclusion Both TE-ACXL and C-CXL were similarly effective. Further follow-up is required to determine whether these techniques are comparable in the long-term.

Increased choroidal thickness is not a disease progression marker in keratoconus

“…The median age was 24.00 years (range [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and individuals in our sample were predominately men (76.3%). Median best corrected visual acuity (BCVA) was 0.90 Snellen (range 0.10-1.00), with glasses or contact lenses.…”

<p>Efficacy of Standard and Accelerated (10 Minutes) Corneal Crosslinking in Keratoconus Stabilization</p>

“…In our study, stabilization occurred, but the results were not statistically significant, perhaps due to the shorter follow-up period (6 months). The results obtained by Madeira et al 10 were also statistically not significant over a follow-up period of 12 months.…”

“…8 Recent studies have concluded that the results of the standard and accelerated protocols are similar, including in children, although the results may vary considering irradiance, time and age, indicating the need for further studies to confirm the efficacy of the Accelerated protocol. 10,11 The objective of this study was to determine whether Accelerated CXL with UVA irradiation of 9 mW/ cm 2 for 10 minutes is as effective as standard CXL with UVA irradiation of 3 mW/cm 2 for 30 minutes in controlling the progression of keratoconus.…”

<p>Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results</p>

“…15,[22][23][24][25][26][27][28][29] In the present study, we evaluated the efficacy of TE-ACXL with a specific accelerated protocol (6 mW/cm 2 of UVA for 15 minutes); there is scarce published evidence. 21,23 Madeira et al had recently concluded that both TE-ACXL (6 mWcm 2 for 15 minutes) and C-CXL were similarly effective. 23 The current study does not find a significant difference in the visual acuity, as expected, since CXL is a treatment that aims at stopping disease progression and typically has a poorly marked effect on cornea shape.…”

“…21,23 Madeira et al had recently concluded that both TE-ACXL (6 mWcm 2 for 15 minutes) and C-CXL were similarly effective. 23 The current study does not find a significant difference in the visual acuity, as expected, since CXL is a treatment that aims at stopping disease progression and typically has a poorly marked effect on cornea shape. This is in agreement with the study done by Waszczykowska et al (accelerated CXL 6 mW/cm2 for 15 minutes), who report no significant improvement in visual acuity.…”