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Database analysis of conventional and accelerated cross-linked keratoconic eyes compared to non-progressive keratoconus

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Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 16:14

Venue: Room 4.6

First Author: : E.Vounotrypidis GERMANY

Co Author(s): :    A. Athanasiou   K. Kortuem   D. Kook   S. Priglinger   M. Shajari   W. Mayer     

Abstract Details


To investigate long-term efficacy of accelerated versus conventional corneal cross-linking (CXL) on progressive keratoconic eyes in comparison to non-progressive keratoconus


Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany.


416 eyes of 281 patients with progressive keratoconus were treated with corneal cross-linking (CXL). 131 eyes of 104 patients were treated with the conventional “Dresden” protocol, while 285 eyes of 235 patients with the “accelerated” protocol (9mW/cm2 for 10 minutes). 260 fellow eyes served as control group. Follow-up period was three years. Analysis included preoperative and postoperative biomicroscopic, CDVA and Scheimpflug topographic imaging


Keratometry values and CDVA improved in both groups. Kmax decreased in the “accelerated” group by 1.0D compared to 0.5D in the “conventional” group (p=0.306). Kmf and TCT did not show any significant changes. 184 of 260 fellow eyes were diagnosed with keratoconus by the time of CXL treatment of the progressive keratoconic eye. 91 of them showed progression and were treated with CXL. Subgroup analysis revealed in non-progressive eyes statistical significant lower Kmax (p<0.05) and Kmf (p<0.05) and thicker TCT (p=0.03) compared to progressive eyes. Further analysis showed no correlation between age and progression of keratoconus (Kruskal-Wallis test,p=0.85)


Both CXL protocols showed similar results concerning stabilization of topographic data and gain in visual acuity with no further progression over the three years follow-up period. Overall, one third of the fellow eyes showed a progression of keratoconus in the same time-span. High keratometric values are associated with a progression of keratoconus, rather than patient’s age.

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