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Updated: May 2, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Corneal stroma demarcation line after standard and high-intensity collagen crosslinking determined with anterior
George D Kymionis1, Konstantinos I Tsoulnaras1, Michael A Grentzelos1
1From Vardinoyiannion Eye Institute of Crete (Kymionis, Tsoulnaras, Grentzelos, Plaka, Liakopoulos, Tsakalis, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, and OKEBE (Mikropoulos), Thessaloniki, Greece; Department of Ophthalmology (Kymionis), Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
Purpose:
To use anterior segment optical coherence tomography (AS-OCT) to compare corneal stroma demarcation line depth after corneal collagen crosslinking (CXL) with 2 treatment protocols.
Setting:
Vardinoyiannion Eye Institute of Crete, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
Design:
Prospective comparative interventional case series.
Methods:
Corneal collagen crosslinking was performed in all eyes using the same ultraviolet-A (UVA) irradiation device (CCL-365). Eyes were treated for 30 minutes with 3 mW/cm(2) according to the standard Dresden protocol (Group 1) or for 10 minutes with 9 mW/cm(2) of UVA irradiation intensity (Group 2). One month postoperatively, 2 independent observers measured the corneal stroma demarcation line using AS-OCT.
Results:
Sixteen patients (21 eyes) were enrolled. Group 1 comprised 7 patients (9 eyes) and Group 2, 9 patients (12 eyes). The mean corneal stroma demarcation line depth was 350.78 μm ± 49.34 (SD) (range 256.5 to 410 μm) in Group 1 and 288.46 ± 42.37 μm (range 238.5 to 353.5 μm) in Group 2; the corneal stroma demarcation line was statistically significantly deeper in Group 1 than in Group 2 (P=.0058, t test for unpaired data).
Conclusion:
The corneal stroma demarcation line was significantly deeper after a 30-minute CXL treatment than after a 10-minute CXL procedure with high-intensity UVA irradiation.
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