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Accelerated CXL treatment for progressive keratoconus in adult populations with corneal thicknesses above and below 400 microns

Poster Details

First Author: B.Knyazer ISRAEL

Co Author(s):    A. Chorny   R. Matlov Kormas                 

Abstract Details


To compare the clinical, biomechanical and tomographic properties of adult patients with keratoconus and thin corneas with those with minimal corneal thickness (MCT) ≥400 µm following treatment with accelerated collagen crosslinking (A-CXL).


We enrolled patients who underwent A-CXL at Soroka University Medical Center due to progressive keratoconus from January 2015–2018 in this retrospective cohort study.


The data was collected from files of patients who underwent A-CXL (9mW/cm2, for 10min) at Soroka University Medical Center. The treatment group (MCT <400 µm after epithelium removal; 32 patients, 32 eyes) was treated with accelerated contact-lens assisted CXL (A-CACXL); the control group (MCT ≥400 µm, 30 patients, 30 eyes) was treated with A-CXL. Assessments occurred before treatment and 12 months postoperatively. Demographic, clinical and tomographic data were obtained from outpatient clinic reports.


: Significant improvement in visual acuity (VA) was evident at 12-month follow-up - for the control group in uncorrected distance VA (logMAR 0.62±0.42 versus 0.43±0.31, p=0.01), and treatment group in best-corrected distance VA (logMAR 0.51±0.30 versus 0.40±0.49, p=0.03). Progression of keratoconus was halted at similar rates for both groups (76.7% treatment, 84.4% control, p=0.21). Mean MCT showed minor but significant thinning at 12-month follow-up compared to baseline (control 463±31 versus 450±35, p>0.01; treatment 398±32 versus 388±41, p=0.02).


A-CACXL halted keratoconus progression in 76.7% of eyes and achieved regression in 33.3% of eyes, with rates comparable to A-CXL. Visual outcomes improved for both groups, with similar keratometry changes. We found A-CACXL is an effective and safe option for keratoconus patients with thin corneas, with results similar to A-CXL treatment in patients with MCT ≥400 µm.

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