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First Author: A.Cummings IRELAND
Co Author(s): R. McQuaid R. Corkin
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Corneal Cross-Linking is an established method for the treatment of keratoconus. Since its development, many scientific studies have been conducted to investigate ways of improving the procedure. Biomechanical stability of the cornea after exposure to UV-A light, and the effect of shortening procedure time has been some of the many topics explored. In the clinic, standard Corneal Cross-Linking (CXL) with 3mW/cm2 UV light may take up to one hour per eye, causing significant stress to the patient, and possible corneal dehydration. Higher intensity Accelerated Cross-Linking (AXL) with 10mW/cm2 shortens treatment time to 10minutes which can be of benefit to both the patient and surgeon. Corneal keratometry of standard CXL versus higher intensity AXL eyes was studied pre- and post-operatively.
Wellington Eye clinic, Dublin, Ireland. 2 surgeons.
33 eyes have been treated with higher intensity AXL (10mW/cmĠ) in a prospective study. To date, 9 eyes have one year follow up. 64 eyes were treated with standard CXL (3mW/cmĠ) in a retrospective study. Corneal Topography and Tomography was measured on each visit post-operatively using the Allegro Topolyzer and Allegro Oculyzer (Wavelight AG).
Prospective clinical trial results show a gradual steepening in the cornea at 1 month (1.12 D), which is commonly seen in corneas after CXL (3mW/cmĠ). At 6 months, 17 eyes show an average flattening of 1.29 D. Results reveal 9 eyes treated with AXL (10mW/cmĠ) show an average reduction of 2.56 Diopters in maximum keratometry 1 year post operatively. Retrospective results after CXL (3mW/cmĠ) show steepening at one month similar to AXL (0.79 D). At 6 months and 1 year, results also show significant flattening of the cornea.
Preliminary clinical trial results 1 year post-operatively suggest CXL and AXL have similar effects on the cornea. By looking at the topographic changes over time, keratometry values show steepening at 1 month post operatively, then improve and remain stable after 3 months post-operatively. These results correlate with CXL, suggesting AXL could be as effective as CXL when permanently halting the progression of keratoconus.