Evaluation of Corneal Stromal Demarcation Line Depth Following Standard and a Modified-Accelerated Collagen Cross-linking Protocol

Abstract

Kymionis and associates published recently their results on high-fluence cross-linking (CXL) for progressive keratoconus. 1 Kymionis G.D. Tsoulnaras K.I. Grentzelos M.A. et al. Evaluation of corneal stromal demarcation line depth following standard and a modified-accelerated collagen cross-linking protocol. Am J Ophthalmol. 2014; 158: 671-675 Abstract Full Text Full Text PDF PubMed Scopus (77) Google Scholar They have analyzed the corneal stromal demarcation line depth after CXL with 9 mW/cm2 of ultraviolet A irradiation for 14 minutes compared to standard Dresden protocol-based CXL with 3 mW/cm2 for 30 minutes. The authors did not observe any significant difference in corneal stromal demarcation line depth between the 2 groups and concluded that their modified-accelerated CXL protocol provides the same treatment depth as the classic Dresden CXL protocol, and it could possibly substitute for classic CXL regarding its efficacy. Evaluation of Corneal Stromal Demarcation Line Depth Following Standard and a Modified-Accelerated Collagen Cross-linking ProtocolAmerican Journal of OphthalmologyVol. 158Issue 4PreviewTo 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/cm2) and a modified-accelerated protocol (14 minutes with 9 mW/cm2). Full-Text PDF ReplyAmerican Journal of OphthalmologyVol. 159Issue 1PreviewWe would like to express our appreciation for Zygoura and associates' letter. It is encouraging to note that the authors actually agree with all of our caveats (detailed in the discussion section of the paper) concerning the use of accelerated corneal cross-linking (CXL) protocols in clinical practice. And we do indeed agree that revisions of CXL parameters should be implemented cautiously, with safety uppermost in mind. Full-Text PDF