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9 mW accelerated cross-linking could replace the 3 mW Dresden protocol in treating progressive keratoconus

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First Author: C.Mazzotta ITALY

Co Author(s):    S. Bagaglia   M. Fruschelli                 

Abstract Details

Purpose:

To assess 5 years safety and efficacy of epithelium-off accelerated 9mW/cm2 in patients with progressive Keratoconus (KC

Setting:

Siena Cross-linking Center

Methods:

prospective long-term interventional study included 65 eyes of 50 patients with a minimum follow-up of 48 months and maximum follow up of 66 months, affected by progressive (stage II) keratoconus according to Krumeich’s staging treated with 9mW epi-off Collagen Cross-Linking The study cohort included 33 eyes of 24 patients from 12 years to 34 years (mean age 23 years). The sub-group of paediatric patients 18 years and under (mean age 16.8 years) included 32 eyes of 26 patients, that were enucleated from the general population and examined separately.

Results:

The follow-up measurements t were compared with baseline values and statistical analysis performed with 2-tailed paired samples Student t test.
 5-years statistically significant data (p <0.05) showed that average UDVA decreased from 0.50 ± 0.11 baseline to 0.34 ± 0.07, average K max decreased from 53.24 ± 1.34 D to 52.1 ±1.39 D average Coma improved from 0.23 ±0.04µm to 0.11 ±0.03µm (p=0.001) and Symmetry Index (SI) decreased from 4.32±1.04 D to 3.43±0.92 D. Corneal OCT showed a demarcation line detection at 245.8 ±18.2 µm average depth in over 75% at first month follow-up

Conclusions:

to ensure a long-lasting stability of keratoconus and secondary ectasia, UV-A power setting and exposure time should be targeted to allow a treatment penetration at least at 250 μm, overcoming the anterior portion of the corneal stroma because the anterior 40% of the central corneal stroma represents the strongest region of the cornea (stiff cornea) 9mW protocol has show safety and efficacy comparable to standard Dresden Coss-Linking Protocol. And may be it’s future repacemnte in halting Keratoconus progression.

Financial Disclosure:

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