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A 12 months follow-up of 3 different protocols of corneal collagen cross-linking for keratoconus: efficacy, anterior segment optical coherence tomography and confocal microscopy

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Session Details

Session Title: Presented Poster Session: Cross-Linking

Session Date/Time: Sunday 06/09/2015 | 15:00-16:30

Paper Time: 15:30

Venue: Poster Village: Pod 4

First Author: : L.Jouve FRANCE

Co Author(s): :    N. Bouheraoua   M. El Sanharawi   O. Sandali   E. Basli   V. Borderie   L. Laroche

Abstract Details


We compared the efficacy and early morphological changes in the cornea following conventional (C-CXL), transepithelial by iontophoresis (I-CXL), and accelerated (A-CXL) collagen cross-linking in keratoconus.


Prospective observational nonrandomized comparative study performed at the Quinze-Vingts National Ophthalmology Hospital.


A total of 45 eyes of 45 patients with progressive keratoconus who underwent corneal collagen crosslinking (CXL) was divided into three groups: C-CXL (n = 15), A-CXL (n = 15), and I-CXL (n = 15). Patients were examined before surgery and at 1, 3, 6 and 12 month intervals following surgery. Density of corneal sub-basal nerves, anterior and posterior keratocytes, corneal endothelium, demarcation line depth, and maximal simulated keratometry values (Kmax) were all assessed.


Compared to preoperative values, the mean corneal sub-basal nerve and anterior stromal keratocyte densities were significantly lower at 6 months in the C-CXL and A-CXL groups (P < 0.001), whereas they returned to preoperative values in the I-CXL group (P = 0.083 and P = 0.909, respectively). The corneal demarcation line was visible 1 month after surgery in 93% of cases (mean depth, 302.8 +/- 74.6 µm) in the C-CXL group, 87.5% (mean depth, 184. 2 +/- 38.9 µm) in the A-CXL group, and 47.7% (mean depth, 212 +/- 36.5 µm) in the I-CXL group (P = 0.006). The Kmax, corneal central thickness, and BSCVA remained stable during the whole study period.


Iontophoresis was associated with weaker damage of corneal sub-basal nerves and anterior keratocytes compared to conventional procedures, but the demarcation line was present in less than 50% of cases and was more superficial than with the traditional procedure.

Financial Interest:


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