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Conventional vs accelerated corneal collagen cross-linking in the treatment of keratoconus

Poster Details

First Author: A.Ng HONG KONG

Co Author(s):    T. Chan   A. Cheng                 

Abstract Details


To compare the effect of conventional corneal collagen cross-linking (CXL) with accelerated corneal collagen cross-linking in treatment of keratoconus.


Hong Kong Sanatorium and Hospital, Hong Kong.


Consecutive cases of progressive keratoconus receiving either conventional (3 mW/cm2 irradiance for 30 minutes) or accelerated CXL (9 mW/cm2 irradiance for 10 minutes) were reviewed retrospectively. Clinical parameters including corrected distant visual acuity (CDVA) and spherical equivalence (SE) were compared between the 2 groups. Topographic parameters including maximal keratometry (Kmax), mean keratometry (Kmean), pachymetry at center (CCT) and pachymetry at thinnest location (TCT) were also compared between groups. Postoperative corneal stromal demarcation line was measured using anterior segment optical coherence tomography.


Fourteen eyes received conventional CXL and 12 eyes had accelerated CXL. Average follow up was 13.9±6.3 months. In the conventional CXL group, there were significant improvements in CDVA, (p=0.021), Kmax (p=0.003) and Kmean (p=0.002). In the accelerated CXL group, no significant change was found in CDVA (p=0.395), Kmax (p=0.388) and Kmean (p=0.952). A significantly greater reduction in Kmax and Kmean were seen in conventional CXL compared to its accelerated counterpart (p=0.001 and 0.015, respectively). The demarcation line was deeper in eyes with conventional CXL (p=0.013) and the depth correlated significantly with the change in Kmean (r=-0.432, p=0.045).


Conventional and accelerated CXL are effective in stabilizing keratoconus progression. Patients undergoing Conventional CXL showed clinical and keratometric improvement with greater corneal flattening at 12 months after treatment, which correlated with a deeper corneal stromal demarcation line.

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