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Accelerated versus conventional corneal collagen cross-linking in the treatment of mild keratoconus: a comparative study

Poster Details

First Author: A.Sherif EGYPT

Co Author(s):                  

Abstract Details



Purpose:

To evaluate the use of accelerated corneal collagen cross-linking in the management of mild and moderate progressive keratoconus in comparison with conventional cross-linking.

Setting:

Rowad Cornea Center, Giza , Egypt

Methods:

Prospective randomized interventional clinical trial. 25 eyes of18 patients randomly divided into 2 groups: Group A: 14 eyes to receive accelerated collagen cross-linking. Group B: 11 eyes to receive standard conventionl cross-linking (Dresden protocol) Cases with grade 1 and 2 Keratoconus (Krumeich classification ) with topographic evidence of progression were included. Pentacam corneal analysis (Pentacam HR, Oculus Optikgerate GmbH) imaging was used: The maximum and minimum keratometry and the central corneal thickness were recorded Ocular response analyzer ORA (Reichert,NY) measurements were carried out Corneal hysteresis CH and corneal resistance factor CRF were recorded . All invistigations were repeated 6 and 12 months after surgery Follow up period : 12 months

Results:

Progressive decrease in the K min, Kmax was noted throughout the follow up period in both accelerated and conventional groups. Kmin was 46.6±1.89 D and 46.37±2.28 at 12 months (p= 0.28 and 0.17) and Kmax was 48.2±1.43D and 50.24±2 D(p=0.02 and 0.09) . BSCVA showed a statistically significant improvement in both groups by 1 year.( p=0.03 and p=0.015 respectively) The CH and CRF showed non-significant improvement in both groups . The CCT showed significant thinning at 6 months (458.42±18.32µm and 438.27±21.77µm) (p=0.0006) and (p=.01) respectively but approached baseline values by 12 months (469.64±20 and 451.73±24.39 µm ) (p=0.028) and (p=0.14).

Conclusions:

Accelerated corneal collagen cross-linking is associated with more flattening of Kmax and more reduction in corneal thickness than conventional cross-linking. Both show comparable improvement in BCVA. Both techniques are safe and effective in arresting the progression of mild keratoconus . FINANCIAL INTEREST: NONE

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