Assessment of accelerated cross-linking with different energy protocols

Abstract

To evaluate the safety and the efficacy of accelerated corneal cross-linking with two different energy protocols. Design Prospective, randomized, interventional study. Patients and Methods: 48 eyes of 26 patients aged 18-38 years with progressive keratoconus. Group A underwent accelerated cross-linking (24 eyes, 5.4 J/cm2), Group B treated with higher ultraviolet-A irradiance (24 eyes, 7.2 J/cm2). Changes in corrected distance visual acuity (CDVA), keratometric data, densitometric data, and specular microscopy were recorded preoperatively and at the 1st, 3rd, and 6th month postoperatively. One month postoperatively, the demarcation line was measured using anterior segment optical coherence tomography. Results: A mean corneal demarcation line was 231.43±27.18 μm in group A and 282.3±21.4 μm in group B and was significantly deeper in group B (P<0.05). Corneal densitometry in the anterior corneal layers was peaked at the 3rd month follow up in both groups. In contrast, middle and posterior stromal layers peaked at the 6th month in both groups (P<0.05). There were no statistically significant changes in CDVA, keratometric values, and endothelial cells in the two groups. Conclusion: We found that accelerated and modified accelerated cross-linking protocols were effective and safe in halting keratoconus progression after a follow-up period of 6 months.