Festina Lente: The Dresden Vs Athens Protocol Of Crosslinking Treatment In Keratoconic Eyes
Published 2024 - 42nd Congress of the ESCRS
Reference: PO671 | Type: Free paper | DOI: 10.82333/bsn6-0555
Authors: Ines Matoc* 1 , Lamia Hasic 2 , Armin Kasumovic 3 , Aida Kasumovic 3 , Dzan Ahmed Jesenkovic 4 , Sanja Sefic Kasumovic 3 , Zoran Vatavuk 1
1Ophthalmology,Sestre milosrdnice UHC,Zagreb,Croatia, 2Medical Faculty,University Sarajevo School of Science and Technology,Sarajevo,Bosnia and Herzegovina, 3Eye Polyclinic dr Sefić,Sarajevo,Bosnia and Herzegovina, 4Faculty of Medicine University of Sarajevo,Sarajevo,Bosnia and Herzegovina
Purpose
To assess outcome differences of corneal crosslinking treatment of keratoconus in the Dresden and Athens protocol.
Setting
Private Eye Polyclinic Dr. Sefic, Sarajevo, Bosnia and Herzegovina
Methods
40 eyes with progressive keratoconus; 20 treated with the Dresden protocol and 20 with the Athens accelerated protocol were included. Data was collected retrospectively. Maximal keratometry (Kmax), flat and steep keratometry values (K1 and K2), apex pachymetry (PA), topographic keratoconus classification (TKC), average pachymetric progression index (AIP), Belin/Ambrosio enhanced ectasia total deviation value (BAD D), back and front corneal elevation, the indices of surface variance (ISV), vertical asymmetry (IVA), height asymmetry (IHA) and height decentration (IHD), keratoconus index (KI), central keratoconus index (CKI), and minimum sagittal curvature (Rmin) were analyzed for differences preoperatively and up to 1 year postoperatively.
Results
Parameters that were significant in the Athens protocol preoperative vs postoperative were pupil C (p=0.005), pachy AP (p=0.016), and BCDVA (p=0.016). Data from the Dresden group showed statistical significance in K2 (p=0.022), TL (p=0.017), BCDVA (p=0.024) and BAD (p=0.04). This reflects greater flattening of the cornea as well as better visual acuity. Postoperative changes between the two protocols showed significance in ΔK1 (p=0.027), ΔK2 (p=0.005), ΔCKI (p=0.038), and ΔTL (p=0.01). K1 and K2 value differences between the 2 groups indicate further flattening of the cornea with the Dresden protocol postoperatively. Comparison of CKI shows significant reduced curvature in the Dresden group as well.
Conclusions
Dresden protocol has a better outcome compared to the accelerated Athens protocol, reflecting stability and no progression of the keratoconus. Although the Athens protocol also had statistical significance in certain parameters, overall significance between the different treatments postoperatively takes precedence over the independent analyses.