Refractive, Topographic, and Aberrometric Results at 2-Year Follow-Up for Accelerated Corneal Cross-Link for Progressive Keratoconus.

Ercüment Bozkurt,Zehra Karaagaç Günaydin,Tugba Kurt,Betul Ilkay Sezgin Akcay,Ahmet Demirok,Engin Bilge Ozgurhan,Yusuf Yildirim

doi:10.1155/2017/5714372

Ercüment Bozkurt, Zehra Karaagaç Günaydin + Show 5 more

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https://doi.org/10.1155/2017/5714372

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Abstract

Purpose. To report the visual, refractive, and corneal topography and wavefront aberration results of accelerated corneal cross-linking (CXL) during a 24-month follow-up. Methods. Forty-seven eyes underwent riboflavin-ultraviolet A-induced accelerated CXL treatment (30 mW/cm2 with a total dose of 7.2 joules/cm2). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical values, keratometry (K) measurements (K steep, K flat, K avg, and K apex), central corneal thickness, and anterior corneal aberrometric analyses including total wavefront error (WFE), total high order aberration (HOA), astigmatism, trefoil, coma, quadrafoil, secondary astigmatism, and spherical aberration were evaluated. Results. The mean UDVA and CDVA were significantly improved at 1 (p = 0.003 and p = 0.004, resp.) and 2 years after treatment (p = 0.001 and p = 0.001, resp.). The mean K steep, K flat, K average, and K apex values were significantly lower than baseline at 12 months (p = 0.008, p = 0.024, p = 0.001, and p = 0.014, resp.) and 24 months (p = 0.014, p = 0.017, p = 0.001, and p = 0.012, resp.). Corneal thickness showed a significant decrease at 1 month. Total HOA and coma decreased significantly at the 12-month (p = 0.001 and p = 0.009, resp.) and 24-month visits (p = 0.001 and p = 0.007, resp.). Conclusion. Accelerated CXL (30 mW/cm2) was found to be effective in improving UDVA, CDVA, corneal topography readings, total HOA, and coma aberrations during the 24-month follow-up.

Highlights

Riboflavin and ultraviolet A (UVA) induced corneal crosslinking (CXL) is an effective treatment for progressive keratoconus and has gained popularity since it has been introduced by Wollensak et al in 2003 [1]
Comprehensive examinations were performed in all cases, including uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, slit-lamp biomicroscopy, Goldmann tonometry, and dilated fundus examination
There was no significant change in mean UDVA and CDVA at 1 month (p = 0.345 and p = 0.148, resp.) and 6 months (p = 0.653 and p = 0.274 resp.) postoperatively

Summary

Introduction

Riboflavin and ultraviolet A (UVA) induced corneal crosslinking (CXL) is an effective treatment for progressive keratoconus and has gained popularity since it has been introduced by Wollensak et al in 2003 [1]. The standard CXL treatment uses UVA light with 3 mW/cm radiation for a duration of 30 min, corresponding to a total energy dose of 5.4 J/cm2 [1]. Accelerated corneal CXL that uses higher energy settings (up to an irradiance of 30 mW/cm2) has gained popularity owing to its shorter treatment duration (3–10 min). Preclinical studies in porcine corneas have revealed that accelerated CXL induces equivalent biomechanical changes as those induced by standard treatment [3, 4]. There are limited reports on the effects of administering accelerated CXL with a total dose of 7.2 J/cm2 [5]. We report the visual, refractive, corneal topography, and wavefront aberration results of this treatment in a 24month follow-up examination

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Results

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