ESCRS - PO494 - Accelerated Versus Conventional Corneal Collagen Crosslinking: Which Is Better Two Years Later?

Accelerated Versus Conventional Corneal Collagen Crosslinking: Which Is Better Two Years Later?

Published 2025 - 43rd Congress of the ESCRS

Reference: PO494 | Type: Free paper | DOI: 10.82333/yw4w-vh86

Authors: Ahmed A.K Elmassry* 1 , Mohamed Shafik 2 , Mohamed Hosni 3 , Ahmed Sharaby 4 , Moones Abdallah 5 , Shaimaa Elbassiouny 6 , Ibtsam Yakout 7 , Miltos Balidis 8

1Ophthalmology,Faculty of Medicine,Alexandria,Egypt;Ophthalmology,ALex eye center,Alexandria,Egypt, 2Ophthalmology,Faculty of Medicine,Alexandria,Egypt, 3Ophthalmology,Faculty of Medicine,Cairo,Egypt, 4Ophthalmology,Ministry of Health,Alexandria,Egypt, 5Ophthalmology,ALex eye center,Alexandria,Egypt, 6Ophthalmology,Ministry of Health,Elbehera,Egypt, 7Ophthalmology,Elmassry Center,Alexandria,Egypt, 8Ophthalmology,Ophthalmica center,Thessaloniki,Greece

Purpose

The aim of the study was to compare the long-term results of accelerated and conventional corneal cross-linking (CXL) for progressive keratoconus.

Setting

Eye Polyclinic "Dr. Sefić", Sarajevo, Bosnia and Herzegovina

Methods

A retrospective clinical study included 33 eyes with progressive keratoconus that underwent conventional CXL (3 mW/cm2, UVA 30 minutes) and 23 eyes that underwent accelerated CXL (9 mW/cm2, UVA 10 min). Exclusion criteria were previous eye trauma or surgery, and other corneal pathologies. Corneal parameters on Scheimpflug tomography, and uncorrected and best corrected distant visual acuity (UDVA and BCDVA) were monitored before the procedure, one year, and two years after the procedure. Parameters that were followed-up included flat, steep and maximal keratometry (K1, K2 and Kmax), pachymetry (PA), thinnest location (TL), anterior and posterior elevation (ELF and ELB), corneal progression indices, Belin-Ambrosio D value (BAD D). 

Results

Conventional CXL group showed a significant decrease in K1, K2, Kmax, PA and TL postoperatively (p<0.01 for all parameters), while accelerated CXL led to a decrease in keratometry values but without statistical significance. Significant difference in the trend of change of parameters postoperatively between the two types of protocols were shown for: K1 (p<0.01), K2 (p=0.02), PA and TL (p<0.01 for both parameters), center of keratoconus index (CKI, p<0.01), BAD D value (p<0.01) and UDVA (p=0.03). Improvements in BCDVA were observed in both groups, but without significant difference in the trend of BCDVA change between them (p=0.08).

Conclusions

Accelerated and conventional CXL protocols are effective methods for stabilizing the progression of keratoconus. Although the conventional protocol was superior to the accelerated protocol in this study, both protocols provided good stabilization after two years of follow-up. In clinical practice, the accelerated protocol has the additional advantage of shorter treatment time, less discomfort for the patient, and faster visual recovery.