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Corneal stromal demarcation line depth following standard and a modified-very high intensity corneal cross-linking protocol

Poster Details

First Author: K.Tsoulnaras GREECE

Co Author(s):    D. Liakopoulos   M. Grentzelos   C. Skatharoudi   N. Tsakalis   G. Kymionis  

Abstract Details


To compare the corneal stromal demarcation line depth using anterior segment optical coherence tomography (AS-OCT) after corneal cross-linking (CXL) using two different treatment protocols: the standard Dresden protocol (30 minutes with 3 mW/cm2) and a modified very high intensity protocol (7 minutes with 18 mW/cm2).


Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece


In this prospective comparative study were enrolled 29 keratoconic patients (32 eyes). All patients underwent CXL using the same high-intensity ultraviolet-A (UV-A) irradiation device (CCL-365, Peschke Meditrade GmbH, Huenenberg, Switzerland). 16 eyes were treated for 30 minutes with 3 mW/cm2 according to the standard Dresden protocol (Group 1), while 16 eyes were treated with a novel modified-very high intensity CXL protocol for 7 minutes with 18 mW/cm2 of UV-A irradiation intensity (Group 2). One month postoperatively, corneal stromal demarcation line depth was measured by two independent observers using AS-OCT.


Corneal stromal demarcation line depth was assessed with no significant difference between observer measurements for both groups (P = .645 Group 1; P = .715 Group 2). Mean corneal stromal demarcation line depth was 341.81 ± 47.02 μm for Group 1 and 313.37 ± 48.85 μm for Group 2. There was no statistically significant difference (P = 0.104) in the corneal stromal demarcation line depth between the two groups. Mean ECD did not change significantly in any group (P = .090 Group 1; P = .103 Group 2). No intraoperative or postoperative complications were noted.


Corneal stromal demarcation line depth using UV-A with 3 mW/cm2 for 30 minutes and 18 mW/cm2 for 7 minutes was similar. It seems that the current modified-accelerated CXL protocol provided the same treatment depth as the standard Dresden protocol. FINANCIAL DISCLOUSRE: NONE

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