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Treatment of progressive keratoconus by a high fluence (18mW), pulsed (10 minutes), accelerated protocol of UVA-induced cross-linking of corneal collagen

Poster Details

First Author: O.Bowes UK

Co Author(s):    S. Coutts   A. Barsam   M. Aamir Ismailjee              

Abstract Details


Progression of corneal ectasia in keratoconus has been successfully arrested by the use of riboflavin and ultraviolet A (UV-A) irradiation in corneal cross-linking. The standard Dresden protocol involves a 30 minute riboflavin soak and 30 minute UV-A exposure (3mW/cm2). There is evidence to suggest potential benefits from a modification of this with a pulsed and accelerated protocol.


This new protocol was introduced at Luton and Dunstable Hospital, UK in October 2014. We present our initial 6 month follow up data. Luton & Dunstable Hospital, UK


The first eleven consecutive eyes (n=11) of patients with documented progression of keratoconus received the new protocol of riboflavin soak for 10minutes, followed by UV-A administration over 6.66 minutes, pulsed for 10 minutes in total at 18mW/cm2 (2 second on, 1 second off).


In our sample, at 6 months follow up, this protocol resulted in a mean corneal flattening of 0.14 dioptres (Kmax) and a mean improvement in visual acuity of 0.19 (LogMAR).


Our results show the biomechanical effect of corneal cross-linking is not negated by optimisation of the protocol variables. Reducing UV exposure and soak time as per an accelerated and pulsed protocol allows for a quicker treatment with equal efficacy and safety profiles. With these preliminary findings the optimised protocol will be used as standard for all future cases.

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