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Updated: Jun 8, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Biomechanical parameters of the cornea after collagen crosslinking measured by waveform analysis
Mohamadreza Sedaghat1, Mostafa Naderi, Mehran Zarei-Ghanavati
1Khatam-Al-Anbia Eye Hospital, Mashad University of Medical Science, Mashad, Iran.
Purpose:
To compare 2 corneal biomechanical parameters--corneal hysteresis (CH) and corneal resistance factor (CRF)--before and after collagen crosslinking (CXL) for keratoconus.
Setting:
Eye Research Center of Mashhad University of Medical Sciences, Khatam-al-Anbia Eye Hospital, Mashhad, and Department of Ophthalmology, Baqiyatallah University of Medical Science, Tehran, Iran.
Design:
Case series study.
Methods:
Topical riboflavin was applied to the deepithelialized cornea every 3 minutes for 30 minutes and every 5 minutes during ultraviolet-A irradiation of the cornea. Corneal hysteresis and CRF were measured by biomechanical waveform analysis (Ocular Response Analyzer) before and 6 months after CXL. The values were compared using the paired Student t test.
Results:
The study comprised 51 patients (56 eyes). The mean age of the patients was 23.27 years ± 6.3 (SD). Before CXL, the mean CH was 7.9 ± 1.5 mm Hg and the mean CRF was 7.3 ± 1.4 mm Hg. Six months after CXL, the mean values were 8.20 ± 1.5 mm Hg and 7.59 ± 1.5 mm Hg, respectively. The changes in CH and CRF were not statistically significant (P>.05). The changes in central corneal thickness and Goldmann-correlated intraocular pressure (IOP) between preoperatively and postoperatively were not statistically significant, although the change in corneal-compensated IOP was (P<.05).
Conclusion:
Although previous in vitro studies found a change in corneal rigidity, this study found no significant change in CH or CHF measured by biomechanical waveform analysis.
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