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Comparison of topographic, refractive, tomographic and pachymetric results after standard and high-fluence corneal cross-linking in pediatric patients with documented progressive keratoconus

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Session Details

Session Title: Cross-linking I

Session Date/Time: Monday 15/09/2014 | 14:30-16:30

Paper Time: 15:00

Venue: Capital Hall A

First Author: : E.Albe ITALY

Co Author(s): :                  

Abstract Details


To report and compare the 24-months topographic, tomographic, refractive and pachymetric outcomes after Standard Corneal Cross Linking (S-CCL) and High-fluence Corneal Cross Linking (Hf-CCL) in pediatric patients with documented progressive keratoconus (KC).


Istituto Clinico Humanitas, Milan, Italy


Prospective, non randomized clinical controlled study including 20 patients undergoing S-CCL (3mw/cm(2)) and 20 patients undergoing Hf-CCL (9mw/cm(2)) below age 14. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), endothelial cell count, topography, pupil center pachymetry (PCP) and Demarcation Line Depth by means of CSO Corneal topographer, Cirrus Optical Coherence Tomography and Pentacam were evaluated at baseline and at 1, 3, 6, 12 and 24 months follow-up.


No significant change in UCVA and BSCVA was observed in Hf-CCL within one year follow-up. Visual acuity improvement was statistically significant (p<0.05) beyond twelve months after surgery in Hf-CCL and six months after surgery in S-CCL. Mean refractive sphere reduction was statistically significant (p<0.05) at six months and close to significance at 12 months postoperatively after S-CCL and not significant after Hf-CCL, up to 24 months post operatively. At 24 months follow-up mean endothelial cell count, keratometry, as well as Ambrosio indexes did not deteriorate with both techniques. Demarcation line depth did not change significantly comparing S-CCl and Hf-CCL. Mean pupil center pachymetry and corneal thickness at 0 and 2 mm decreased significantly after S-CCL, to recover within one year follow-up and did not change significantly after Hf-CCL.


2 years after surgery, Hf-CCL appears to be effective in stabilizing eyes of pediatric patients with progressive keratoconus, restoring sooner than S-CCL the preoperative UCVA and BSCVA, without inducing significant change in corneal APP, AK, and pachymetry, despite reaching the same depth of demarcation line of S-CCL.

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