Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Correlation between central stromal demarcation line depth and flattening of the cornea after corneal cross-linking comparing two different treatment protocols

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Session Details

Session Title: Presented Poster Session: Cross-linking

Session Date/Time: Sunday 11/09/2016 | 09:30-11:00

Paper Time: 10:10

Venue: Poster Village: Pod 3

First Author: : N.Pircher AUSTRIA

Co Author(s): :    J. Lammer   A. Gschliesser   R. Donner   S. Pieh   G. Schmidinger  

Abstract Details


A corneal stromal demarcation line (DL) induced by corneal cross-linking (CXL) has lately been suggested as a possible surrogate parameter for the flattening effect and success of the CXL-procedure. Aim of this study was to investigate the correlation between depth of the DL in the center of the cornea 1 month (mo) and reduction in maximal keratometry values (Kmax) 12mo after CXL treatment as well as comparing the effect in two different treatment protocols.


Department of Ophthalmology and Optometry, Medical University of Vienna


Treatment-naive subjects with keratoconus were treated either following the Standard Dresden Protocol (SDP, 30 minutes (min) Riboflavin + 20% Dextran [Peschke D] soaking, 30min irradiation UVX-1000, 3mW/cm2) or an Accelerated CXL Protocol (ACP, 10min HPMC [Vibex Rapid] soaking, 10min irradiation UVX-2000, 9mW/cm2). Depth of the DL was measured using Visante anterior segment OCT (Carl Zeiss Meditec Inc.) imaging 1mo post-operatively (OP). Kmax (preOP) and change in Kmax (preOP - 12mo postOP) were assessed using corneal topoghrapy (Pentacam HR tomography, Oculus GmBH).


50 eyes were treated according to the SDP and 36 eyes to the ACP. PreOP mean±SD Kmax was 57.26±6.97 D in the SDP group and 56.82±6.36 D in the ACP group (p=0.10). A DL was observed in all eyes of both groups [(326.57±76.64 µm SDP and 168.74±73.15 ACP (p<0.001)]. Mean change in Kmax was -1.32±2.04 D after 12mo in the SDP group (p<0.001) and -0.77±2.36 D in the ACP group (p=0.75). No statistically significant correlation between depth of the DL after 1mo and change in Kmax after 12mo was found in either of the groups (Pearson r: -0.09 and -0.02)


Different CXL treatment protocols seem to induce different depths of the DL. Even though eyes that were treated following the Standard Dresden Protocol showed a deeper DL and a significant change in Kmax at 12 mo, the interpretation of the stromal depth of the DL as a surrogate parameter for the effect of the procedure may be doubted.

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