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Accelerated (10mW/cm2) vs conventional (3mW/cm2) corneal collagen cross-linking for the treatment of progressive keratoconus

Poster Details

First Author: Sanctis ITALY

Co Author(s):    L. Bertaina   R. Penna   M. Catalano   F. Grignolo           

Abstract Details


To compare the outcome of accelerated corneal collagen crosslinking (CXL) and conventional CXL.


Department of Surgical Sciences, Ophthalmology Institute, University of Turin, Italy.


Consecutive patients with progressive keratoconus were included: 32 eyes of 28 patients had accelerated CXL (30 minutes riboflavin 0.1% (Ricrolin, Sooft, Italy) presoak; 9 minutes of 10 mW/cm2 ultraviolet-A (UVA) exposure), and 49 eyes of 47 patients had conventional CXL (30 minutes riboflavin 0.1% presoak; 30 minutes of 3 mW/cm2 UVA exposure). The postoperative changes in Snellen uncorrected and corrected distance visual acuity (UDVA and CDVA), Pentacam HR (Oculus; Germany) mean keratometry (Km), central corneal thickness (CCT) and endothelial cell density (ECD) with accelerated and conventional CXL were compared. The follow-up was 1 year.


The improvement of postoperrative visual acuity was not significantly different (p>0.05) between methods. After accelerated CXL, the UDVA improved from 0.33±0.19 to 0.45±0.37 (p=0.08), and the CDVA from 0.67±0.22 to 0.75±0.23 (p=0.01); after conventional CXL, the UDVA improved from 0.30±0.23 to 0.36±0.22 (p=0.08), and the CDVA from 0.64±0.25 to 0.75±0.20 (p=0.001). The reduction of postoperative Km was statistically significant after conventional CXL (from 47.18±2.69 to 46.66±2.74; p=0.001), but not after accelerated CXL (from 47.10±3.98 to 47.13±3.91; p=0.87). The reduction of postoperative CCT was statistically significant (p<0.001), and comparable between methods. The postoperative ECD did not show significant changes with both methods.


The efficacy and safety of accelerated CXL with 10 mW/cm2 UVA light exposure appear comparable to those of conventional CXL. However, a longer follow-up is necessary to validate these findings.

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