Efficacy of different accelerated corneal crosslinking protocols for progressive keratoconus

Abstract

Purpose: To evaluate the efficacy of different accelerated corneal crosslinking (CXL) treatment protocols in patients with progressive keratoconus.

Setting: Marmara University School of Medicine, Istanbul, Turkey.

Design: Retrospective case series.

Methods: Patients with progressive keratoconus had 9 mW accelerated CXL (10 minutes; 9 mW/cm²), 30 mW continuous-light accelerated CXL (4 minutes; 30 mW/cm²), or 30 mW pulsed-light accelerated CXL (8 minutes [1 second on/1 second off]; 30 mW/cm²).

Results: Of 134 eyes, 34 eyes had conventional CXL, 45 had 9 mW accelerated CXL, 28 had 30 mW continuous-light accelerated CXL (4 minutes, 30 mW/cm²), and 27 eyes had 30 mW pulsed-light accelerated CXL. The uncorrected (UDVA) (P < .001 both) and corrected (CDVA) distance visual acuities increased in with conventional CXL and 9 mW accelerated CXL (P = .001 and P = .002, respectively). With 30 mW continuous accelerated CXL, only CDVA improved (P = .019). With 30 mW pulsed accelerated CXL, UDVA and CDVA did not change significantly (P > .05). With conventional CXL and 9 mW accelerated CXL, all keratometric (K) readings (K1, K2, mean K, maximum K) improved significantly (conventional CXL: P = .014, P = .002, P = .008, and P < .001, respectively; 9 mW accelerated CXL: all P < .001). With 30 mW, no K values changed significantly compared with baseline (all groups P > .05).

Conclusion: Although 30 mW accelerated CXL treatment modalities appeared to be effective in stabilizing keratoconus progression, they seemed less effective in achieving topographic improvement.