Abstract
Objective. To compare one-year results of vision, corneal aberrometry and contrast sensitivity (CS) in low light conditions between 5- and 10-minute accelerated cross-linking (CXL) protocols. Methods. Thirty eyes were evaluated in each studied group. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity by the SC-2000 Snellen chart, corneal higher order aberrations using the OPD Scan III and CS using MonCv3System was tested under mesopic (20 lux) and scotopic (0.5 lux) light conditions at pre-CXL and 6 and 12 months post-CXL. Results. At 12 months, a mean improvement of 0.06±0.22 (22.2%) and 0.02±0.25 logMAR (7.9%) in mesopic UDVA and 0.01±0.13 (14.3%) and 0.07±0.13 logMAR (87.9%) in mesopic CDVA was observed in the 5- and 10-minute groups, respectively. Mean decline in scotopic UDVA was 0.01±0.16 (1.0%) and 0.03±0.17 logMAR (11.9%) and mean improvement in scotopic CDVA was 0.03±0.10 (35.5%) and 0.02±0.07 logMAR (22.2%), respectively. Inter-group differences in the decrease of corneal aberrations were not statistically significant. Among CS variables, only inter-group changes in corrected CS 0.5 to 2.2 was significantly different (all P<0.050). The linear regression analysis showed that these differences were related to baseline values not CXL protocols; corrected CS 0.5 (Pgroup=0.261 and Pbaseline value<0.001), CS 1.1 (Pgroup=0.250 and Pbaseline value<0.001), and CS 2.2 (Pgroup=0.101 and Pbaseline value=0.054). Conclusions. Changing the intensity of UV in cross-linking from 18mW/ cm2 to 9mW/ cm2 does not affect the visual function under low-light conditions.
Highlights
Keratoconus leads to progressive irregular astigmatism and deteriorating visual acuity.Corneal cross-linking (CXL) with standard and different accelerated protocols contributes to ectasia stabilization, corneal flattening, and reduction of irregular astigmatism by increasingRomanian Journal of Ophthalmology 2018; 62(4): 270-276 collagen cross-links and corneal strengthening [1].Today, accelerated protocols, which reduce the irradiation time while maintaining the total power, are receiving high consideration
Keratoconus leads to irregular astigmatism, increasing aberrations, and deteriorating visual acuity [9,10]
Our result showed that keratoconic patients had better mesopic VA than scotopic VA
Summary
Keratoconus leads to progressive irregular astigmatism and deteriorating visual acuity.Corneal cross-linking (CXL) with standard and different accelerated protocols contributes to ectasia stabilization, corneal flattening, and reduction of irregular astigmatism by increasingRomanian Journal of Ophthalmology 2018; 62(4): 270-276 collagen cross-links and corneal strengthening [1].Today, accelerated protocols, which reduce the irradiation time while maintaining the total power, are receiving high consideration. Corneal cross-linking (CXL) with standard and different accelerated protocols contributes to ectasia stabilization, corneal flattening, and reduction of irregular astigmatism by increasing. A one-year study of the 10minute versus the standard method [4] showed a comparable significant enhancement of visual acuity and decline of refraction with the two methods. In an 18-month RCT [3], we observed similar vision and refraction results with the standard and 5-minute methods, but there was better corneal flattening with the standard method. One study compared various accelerated methods versus the standard and showed better vision improvement with the 5-minute protocol than the 10-minute one [5]. In a 2011 study on 70 keratoconus eyes by this team [6], we demonstrated reduced corneal higher order aberrations (HOAs) following the 5minute protocol
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