Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results.

Area of Science:

• Ophthalmology
• Corneal Crosslinking
• Keratoconus Treatment

Background:

• Progressive keratoconus requires effective treatments to halt corneal steepening and visual deterioration.
• Accelerated corneal collagen crosslinking (ACXL) offers a faster alternative to standard protocols.
• The role of light delivery patterns (pulsed vs. continuous) in ACXL efficacy is not fully elucidated.

Purpose of the Study:

• To compare the functional outcomes of epithelium-off pulsed light accelerated corneal collagen crosslinking (pl-ACXL) versus continuous light accelerated corneal collagen crosslinking (cl-ACXL).
• To evaluate the impact of light delivery patterns on corneal stromal penetration and patient vision.
• To assess the safety and efficacy of both pl-ACXL and cl-ACXL in patients with progressive keratoconus.

Main Methods:

• A prospective, comparative study involving 20 patients with progressive keratoconus.
• Two groups underwent epithelium-off ACXL: one with pulsed UV-A light (pl-ACXL) and the other with continuous UV-A light (cl-ACXL).
• Functional outcomes, corneal topography, aberrometry, pachymetry, and endothelial cell count were assessed over 12 months.

Main Results:

• One-year follow-up demonstrated stability of keratoconus in both pl-ACXL and cl-ACXL groups.
• Epithelium-off pl-ACXL resulted in superior functional outcomes and deeper stromal penetration compared to cl-ACXL.
• No endothelial damage was observed in either treatment group throughout the follow-up period.

Conclusions:

• Oxygen availability is crucial for the collagen crosslinking reaction.
• Pulsed light treatment enhances intraoperative oxygen availability, leading to improved postoperative functional outcomes in ACXL.
• Epithelium-off pl-ACXL is a safe and potentially more effective treatment for progressive keratoconus than cl-ACXL.