Efficacy of different accelerated corneal crosslinking protocols for progressive keratoconus

Abstract

Purpose To evaluate the efficacy of different accelerated corneal crosslinking (CXL) treatment protocols in patients with progressive keratoconus. Setting Marmara University School of Medicine, Istanbul, Turkey. Design Retrospective case series. Methods Patients with progressive keratoconus had 9 mW accelerated CXL (10 minutes; 9 mW/cm²), 30 mW continuous-light accelerated CXL (4 minutes; 30 mW/cm²), or 30 mW pulsed-light accelerated CXL (8 minutes [1 second on/1 second off]; 30 mW/cm²). Results Of 134 eyes, 34 eyes had conventional CXL, 45 had 9 mW accelerated CXL, 28 had 30 mW continuous-light accelerated CXL (4 minutes, 30 mW/cm²), and 27 eyes had 30 mW pulsed-light accelerated CXL. The uncorrected (UDVA) (P < .001 both) and corrected (CDVA) distance visual acuities increased in with conventional CXL and 9 mW accelerated CXL (P = .001 and P = .002, respectively). With 30 mW continuous accelerated CXL, only CDVA improved (P = .019). With 30 mW pulsed accelerated CXL, UDVA and CDVA did not change significantly (P > .05). With conventional CXL and 9 mW accelerated CXL, all keratometric (K) readings (K1, K2, mean K, maximum K) improved significantly (conventional CXL: P = .014, P = .002, P = .008, and P < .001, respectively; 9 mW accelerated CXL: all P < .001). With 30 mW, no K values changed significantly compared with baseline (all groups P > .05). Conclusion Although 30 mW accelerated CXL treatment modalities appeared to be effective in stabilizing keratoconus progression, they seemed less effective in achieving topographic improvement.