Evaluation of corneal stromal demarcation line depth following standard and a modified-accelerated collagen cross-linking protocol

Am J Ophthalmol. 2014 Oct;158(4):671-675.e1. doi: 10.1016/j.ajo.2014.07.005. Epub 2014 Jul 15.

Abstract

Purpose: To compare the corneal stromal demarcation line depth using anterior segment optical coherence tomography (AS-OCT) after corneal collagen cross-linking (CXL) using 2 different treatment protocols: the standard Dresden protocol (30 minutes with 3 mW/cm(2)) and a modified-accelerated protocol (14 minutes with 9 mW/cm(2)).

Design: Prospective, comparative study.

Methods: Forty-three keratoconic patients (52 eyes) were enrolled. All patients underwent CXL using the same high-intensity ultraviolet-A (UV-A) irradiation device. Twenty-six eyes were treated for 30 minutes with 3 mW/cm(2) according to the standard Dresden protocol (Group 1), while 26 eyes were treated with a novel modified-accelerated CXL protocol for 14 minutes with 9 mW/cm(2) of UV-A irradiation intensity (Group 2). One month postoperatively, corneal stromal demarcation line depth was measured by 2 independent observers using AS-OCT.

Results: Corneal stromal demarcation line depth was assessed with no significant difference between observer measurements for both groups (P = .676 for Group 1 and P = .566 for Group 2). Mean corneal stromal demarcation line depth was 337.00 ± 46.46 μm for Group 1 and 322.91 ± 48.28 μm for Group 2. There was no statistically significant difference (P = .243) in the corneal stromal demarcation line depth between the 2 groups.

Conclusions: Corneal stromal demarcation line depth using UV-A with 3 mW/cm(2) for 30 minutes and 9 mW/cm(2) for 14 minutes was similar. A modified-accelerated protocol of 14 minutes of CXL provided the same treatment depth as the classic Dresden protocol.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Collagen / metabolism
  • Corneal Pachymetry
  • Corneal Stroma / metabolism
  • Corneal Stroma / pathology*
  • Cross-Linking Reagents / therapeutic use*
  • Female
  • Humans
  • Keratoconus / drug therapy*
  • Keratoconus / metabolism
  • Keratoconus / pathology
  • Male
  • Middle Aged
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies
  • Riboflavin / therapeutic use
  • Tomography, Optical Coherence
  • Ultraviolet Rays
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin