Accelerated versus Conventional Corneal Collagen Cross-Linking in The Treatment of Keratoconus

Abstract

Background: corneal collagen cross-linking (CXL) is one of the interesting topics in corneal surgery, with several recent modifications of the original Dresden protocol under investigation. Accelerated CXL is one of the exciting modifications of the original technique but with few published results. It Objective: the aim of the present study was to compare the effect of accelerated (both continuous and pulse) crosslinking on the keratoconic cornea versus conventional protocol. We stuck to inclusion and exclusion criteria of the study. Patients and methods: in this study we evaluated 90 eyes; 30 eyes received standard Dresden protocol (S-CXL), 30 eyes received continuous light accelerated protocol (cl-ACXL), and 30 eyes received pulsed light accelerated protocol (pl-ACXL). The refractive status, visual acuity, corneal topography, central corneal thickness and corneal biomechanics were evaluated preoperatively, at 1 st month, 3rd month, 6th month and 12th month postoperative. Results: all groups showed an improvement of MRSE, UCVA and BCVA one year after surgery. The central corneal thickness (CCT) markedly decreased at 1st month follow-up, then gradually increased till 12th month but still below the baseline. Both maximum and minimum keratometry (K-max and K-min) decreased significantly at 12th month follow-up. The corneal biomechanics; corneal hysteresis (CH) and corneal resistance factor (CRF) showed no significant changes all over the follow-up period. Conclusion: the results in this study showed that both continuous and pulsed light accelerated cross-linking are as safe as standard Dresden protocol in halting keratoconus disease.