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Short-term refractive outcomes and safety of accelerated corneal collagen cross-linking compared to conventional cross-linking

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Session Details

Session Title: Cross-linking I

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

Paper Time: 15:36

Venue: Capital Hall A

First Author: : A.Ranganath INDIA

Co Author(s): :    R. Shetty   S. D Souza   A. Sinha Roy   H. Piyush Matalia     

Abstract Details


To evaluate the safety of accelerated corneal cross-linking with riboflavin (ACXL) and its short-term effectiveness in comparison with conventional corneal cross-linking with riboflavin (CXL)


Keratoconus patients attending a tertiary eye care centre in Bangalore, Karnataka, India


Patients with progressive keratoconus underwent cross-linking with the ACXL group receiving UVA radiation of 30mW/cm2 (duration of 4 minutes) and CXL group receiving UVA radiation of 3mW/cm2 (duration of 30 minutes). Outcome measures studied were corrected distance visual acuity (CDVA), mean manifest cylinder and keratometry, stromal haze and corneal thickness. Endothelial cell density was studied in ACXL group to assess the safety. Data collected pre-operatively and up to six months post-operatively was analyzed.


Of the 82 eyes studied, 40 eyes underwent ACXL, and 42 eyes underwent CXL. The CDVA and manifest cylinder remained stable in both groups at six months (p>0.05). No patient lost more than two lines of CDVA in both groups. Post-surgery, keratometry remained stable in ACXL group, but decreased in CXL group (p<0.05). No progression of keratoconus was seen in any patient at six months. Corneal haze increased post-surgery in both groups (p<0.001) but intensity of haze was higher in the CXL group compared to ACXL (p<0.001 at 3 and 6 months). There was an inverse relation between corneal haze and thickness post-operatively. No endothelial cell changes were noted in ACXL group.


Accelerated corneal cross-linking, like CXL, appears to be a safe procedure. Keratometry outcomes were better with CXL but further long-term studies are needed to evaluate the biomechanical efficacy of ACXL.

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