Conventional vs accelerated corneal cross-linking in the treatment of post-refractive surgery ectasia: a long-term randomised controlled trial

Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 14:58

Venue: Room A3, Podium 3

First Author: : H.Khairy EGYPT

Co Author(s): :    K. Said-Ahmed   M. Elsawy   S. Mandour              

Abstract Details

Purpose:

The aim of this study is to compare the clinical outcomes of the conventional CXL and the AC CXL in patients with progressive corneal ectasia post Laser refractive surgery or penetrating keratoplasty.

Setting:

This was a prospective, randomized study recruited patients from Menoufia University Hospitals (Egypt) and its satellite clinics.

Methods:

Eligible patients were adults aged above 18 years. They have been diagnosed clinically with progressive corneal ectasia following refractive surgery procedure (LASIK, PRK, ReLEx smile), or penetrating keratoplasty with CCT above 400µ. In the Conventional CXL group Ultraviolet A radiation of 365 nm wavelength (CCL-365 vario, Peschke Meditrade GmbH, Switzerland), and an irradiance of 3mW/cm2 (spot size 7mm), at a distance of 45 mm from the cornea, was applied for a period of 30 min, delivering a dose of 5.4 J/cm2. While in the Accelerated CXL group, an irradiance of 18 mW/cm2 was applied for 5 minutes.

Results:

54 eyes had the Conventional CXL, and 57 had the Accelerated CXL. 87 eyes had ectasia post Laser surgery while 24 eyes had ectasia post penetrating keratoplasty. The conventional group showed significant improvement in the K-max from 52.19±1.88 D preoperatively to 50.98±1.77 D at 12 months postoperatively (p<0.05).Similarly, the Accelerated group improved from 52.17±1.81 D preoperatively to 51.27±1.76 D postoperatively (p<0.05), with no statistical significant difference between the 2 groups. Both groups had significant improvement in the best corrected visual acuity, and the manifest refraction with no significant difference between the 2 groups.

Conclusions:

Both standard CXL and accelerated CXL are safe and effective treatment in halting ectasia after corneal refractive surgery. The Accelerated CXL results are comparable to the Standard CXL with short time exposure of the cornea to ultraviolet irradiation, leading to reduced operation time, and reduced postoperative ocular pain, and corneal haze.

Financial Disclosure:

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