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Accelerated vs standard corneal cross-linking for progressive keratoconus in Syria

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First Author: A.Salman SYRIA

Co Author(s):    T. Darwish   M. Ghabra   R. Shaaban   A. Ali   Y. Haddeh        

Abstract Details

Purpose:

To compare and evaluate the outcomes of accelerated and standard corneal cross-linking in the treatment of progressive keratoconus.

Setting:

Department of ophthalmology, Tishreen University, Lattakia, Syria.

Methods:

In this retrospective comparative study, sixty-three eyes of 40 patients with progressive keratoconus were divided into two groups; 27 eyes in group 1 were treated with an accelerated protocol (10 mW/cm2, 9 min), and 36 eyes in group 2 were treated with the standard method (3 mW/cm2, 30 min). The visual acuity, refraction, corneal topography, corneal tomography, the anterior and posterior corneal HOAs, were assessed preoperatively and 18-30 months postoperatively. The data was statistically analyzed.

Results:

The LogMAR UDVA and CDVA values were improved in both groups, postoperatively. The flattening in the anterior keratometry readings were significantly higher in group two (P > 0.001, all), whereas the maximum posterior keratometry (AKb) values increased. The reduction in the minimum corneal thickness (ThKmin) was significantly greater (36.49um) in group two, compared to (10.85um) in group one. There was a significant increase in the posterior average keratometry, and a significant decrease in the posterior cylinder values in S-CXL (P = 0.03, P = 0.008, respectively). the anterior trefoil and coma were significantly improved in group 1 and 2, respectively.

Conclusions:

An accelerated cross-linking protocol, using 10 mW/cm2 for 9 minutes, showed better visual improvement and less pachymetric reduction when compared to the standard protocol, but the anterior corneal flattening, the posterior corneal steepening and the change in the posterior astigmatism were significantly higher in standard protocols, while corneal HOAs were improved in both protocols.

Financial Disclosure:

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