Long-term outcomes of different corneal cross-linking protocols in progressive keratoconus
First Author: S.Akkaya Turhan TURKEY
Co Author(s): F. Aydın E. Toker
To evaluate the long-term efficacy of different corneal cross-linking (CXL) protocols in progressive keratoconus patients.
Marmara University, School of Medicine, Department of Ophthalmology
Sixty-one eyes of 45 keratoconus patients were included in this study. Patients received one of the 3 treatment protocols; Conventional CXL group (20 eyes; 3 mW/cm2 30 minutes); accelerated epi-off CXL group (19 eyes; 9 mW/cm2 10 minutes) and accelerated epi-on CXL group (22 eyes; 30 mW/cm2-4 minutes and 45 mW/cm2-2 minutes). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE) and keratometry values (K1, K2, and Kmax) were evaluated preoperatively and at the last follow-up.
The mean follow-up period of the patients was 53.0 ± 15.4 months (36-79 months). BCVA, UCVA, and SE did not change significantly in any treatment group (p>0.05). While there was a significant reduction in mean keratometry values of conventional CXL group (K1 0.3 diopters(D), p=0.004; K2 0.4D, p= 0.147; Kmax 1.1D, p<0.0001) and accelerated CXL group (K1 1.1D, p=0.005; K2 0.9D, p=0.03; Kmax 1.0D, p=0.04) at last follow-up, no significant change was observed in accelerated epi-on CXL group (K1 0.1D, p=0.154; K2 0.2D, p=0.192; Kmax 0.4D, p=0.330). The changes in keratometry values did not differ significantly between treatment groups.
While accelerated epi-on CXL appears to be effective in stabilizing keratoconus progression, conventional and accelerated epi-off CXL also provide an improvement in keratometry values on long-term follow-up.
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