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Updated: Apr 26, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Safety of high-intensity corneal collagen crosslinking
George D Kymionis1, Michael A Grentzelos1, Vardhaman P Kankariya1
1From Vardinoyiannion Eye Institute of Crete (Kymionis, Grentzelos, Kankariya, Liakopoulos, Portaliou, Tsoulnaras, Karavitaki, Pallikaris), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; the Department of Ophthalmology (Kymionis, Kankariya, Portaliou), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Purpose:
To evaluate the safety of a new high-intensity corneal collagen crosslinking (CXL) treatment protocol for keratoconus.
Setting:
Vardinoyiannion Eye Institute of Crete, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
Design:
Prospective interventional case series.
Methods:
Patients with progressive keratoconus had CXL using a new treatment protocol with 9 mW/cm(2) irradiance for duration of 10 minutes. The rate of reepithelialization, endothelial cell density (ECD), corrected distance visual acuity (CDVA), and steep and flat keratometry (K) values were evaluated preoperatively and 3 months postoperatively.
Results:
Nine patients (10 eyes) were enrolled. No intraoperative or early postoperative complications were observed in any patient. The ECD did not change significantly 3 months postoperatively (P=.169). The CDVA improved from 0.19 logMAR ± 0.20 (SD) preoperatively to 0.10 ± 0.16 logMAR 3 months postoperatively; however, the improvement did not attain significance (P=.141). No eye lost lines of CDVA. The mean steep K readings decreased significantly from 48.04 ± 2.57 diopters (D) preoperatively to 46.51 ± 2.81 D 3 months postoperatively (P=.047); the mean flat K readings did not change significantly postoperatively (P=.285).
Conclusions:
Corneal collagen crosslinking at 9 mW/cm(2) irradiance for 10 minutes did not cause significant changes in ECD or intraoperative or early postoperative complications. None patient lost a line of CDVA 3 months after the procedure.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
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