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15mW-pulsed-light high-irradiance accelerated cross-linking in progressive keratoconus: 2-years clinical results

Poster Details

First Author: S.Bagaglia ITALY

Co Author(s):    C. Mazzotta                    

Abstract Details


To assess functional results and corneal microstructural changes after 15mW/cm2 high-irradiance pulsed-light accelerated crosslinking (A-CXL) with 5.4 J/cm2 standard Energy dose


Siena Crosslinking Center, Italy University of Siena, Dept of Ophthalmology


Prospective interventional study including 132 eyes of 96 patients, mean age 23.7 �Â�± 4.3 years, with stage II keratoconus. After epithelium removal, 10 min stromal soaking with Riboflavin 0.1% solution, all patients underwent high-irradiance 15mW/cm2 pulsed-light A-CXL for 6.00 minutes of UV-A irradiation (1 sec ON/1 sec OFF) maintaining a total UV-A exposure time of 12 min, E dose (Fluence) 5.4 J/cm2. 2-year follow-up examination included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Scheimpflug tomography (Sirius C.S.O, Florence, Italy), in vivo confocal microscopy (IVCM), (HRT II, Heidelberg, Germany) and corneal optical coherence tomography (i-Vue OCT, Fremont, USA)


Results: Re-epithelialization was complete 72 hours after treatment. OCT scans documented a demarcation line at an average depth of 280�Â�±32 �Â�µm. IVCM scans documented a regular basal epithelial healing 72 hours after treatment, associated with the presence of sub-epithelial nerves. UDVA and CDVA showed statistically significant changes from 0.51 �Â�± 0.106 Log MAR at baseline to 0.309 �Â�± 0.074 (P 0.0001) and 0.271 �Â�± 0.144 Log MAR at baseline to 0.135 �Â�±0.1 Log MAR (P 0.0023) respectively. Coma Values improved significantly since the first postoperative month (P 0.0004).


The study confirms the safety and efficacy of high-irradiance 15mW/cm2 pulsed-light A-CXL in stabilizing keratoconus progression at 24-month follow-up, without complications.

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