Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus: 1-year results.

Abstract

To investigate the safety and efficacy of a new protocol for transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus treatment. There were 26 patients (26 eyes) diagnosed with keratoconus enrolled in the study and treated with transepithelial accelerated corneal collagen cross-linking. The corneas were irradiated using UVA light for 5min and 20s with 45mW/cm2 irradiance and pulsed illumination (1:1). The follow-up examinations were performed at 1day, 1month, 3months, 6months, and 1year postoperatively. At each follow-up, the patients received a complete ophthalmologic examination that included visual acuity, manifest refraction, corneal topography, endothelial cell density, and ORA. The operations were uneventful, and there were no complications during follow-up. At 1year after the procedure, the uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of the treated eyes were significantly improved compared to the pretreatment values (P=0.012, 0.041, respectively). Additionally, 65.4% of eyes gained at least 1 line in CDVA, and 42.3% of eyes showed a reduction in at least 0.5D in astigmatism. The maximum keratometry (K max), corneal thickness, corneal endothelial cell density and corneal biomechanics were stable at each visit. Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability was safe for keratoconus treatment and partially prevented disease progression. Therefore, further studies with large patient cohorts and longer follow-up periods are recommended.