Posters

Comparison of clinical and biomechanical changes in different uncommon accelerated cross-linking protocols in keratoconus: 12 months' follow-up

Poster Details

First Author: J.Artaechevarria Artieda SPAIN

Co Author(s):    I. Morote   N. Alba                 

Abstract Details

Purpose:

To compare the clinical and biomechanical changes between six different accelerated cross-linking (ACXL) protocols in progressive keratoconus at 12 months.

Setting:

Department of Ophthalmology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Methods:

In this retrospective study, 63 eyes of 49 patients with progressive keratoconus were included in 6 groups with different accelerated cross-linking protocols: Group I (8 patients, 5.4 J/cm2, 15mWx12min, pulsed), Group II (11 patients, 5.4 J/cm2, 6mWx15min, continuous), Group III (16 patients, 5.4 J/cm2, 9mWx10min, continuous), Group IV (13 patients, 5.4 J/cm2, 30mWx6min, pulsed), Group V (8 patients, 7.2 J/cm2, 15mWx16min, pulsed) and Group VI (6 patients, 7.2 J/cm2, 30mWx8min, pulsed). Best corrected visual acuity (BCVA), subjective manifest refraction and corneal keratometric and topographic parameters were studied previously and at 12 months. Postoperative complications were noted.

Results:

11 patients were female (22,45%) and 38 male (77,55%). Improvement in the BCVA was significant only in Group I(p=0.042). Decrease in Kmax was statistically significant in groups II (-1.045D;p=0.041), III (-1.296D;p=0.017), IV (-1.108D;p=0.018) and V (-2.157D;p=0.018). Flattening of the Kmean was significant in groups II (-0.282D;p=0.028), IV (-0.48D;p=0.008) and V (-0.864D;p=0.028), as well as the K1 flat in groups IV(p=0.01) and V(p=0.028) and K2 steep in group IV(p=0.036). There was no significant difference in the thinnest pachymetry in any of the groups. Two patients had anterior stromal scarring and one patient presented an important corneal flattening. Progression was noticed in one patient.

Conclusions:

The accelerated CXL protocols with irradiations of 6mWx15min, 9mWx10min, 30mWx6min and 15mWx16min showed significant topographical improvement, specially the last one, but no changes in the visual acuity nor in the refractive measures were observed. In our opinion, the relationship between the type of keratoconus and the best protocol to apply in each patient is difficult to stablish, possibly due to the great clinical variability of this pathology. This study is limited by the number of patients, but it could be the basis of larger studies to stablish new protocols and to determine the most adequate protocol in each case.

Financial Disclosure:

None