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Updated: Apr 15, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Corneal stromal demarcation line determined with anterior segment optical coherence tomography following a very high
George D Kymionis1, Konstantinos I Tsoulnaras, Dimitrios A Liakopoulos
1*Vardinoyiannion Eye Institute of Crete (VEIC), Department of Ophthalmology, Faculty of Medicine, University of Crete, Heraklion, Greece; and †Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miller School of Medicine, Miami, FL.
Purpose:
To evaluate corneal stromal demarcation line depth after very high intensity (18 mW/cm) ultraviolet-A irradiation for a 5-minute corneal collagen cross-linking (CXL) protocol with the use of anterior segment optical coherence tomography.
Methods:
This prospective interventional study enrolled 14 patients (18 eyes) with progressive keratoconus who underwent CXL with an ultraviolet-A irradiation intensity of 18 mW/cm for 5 minutes. One month postoperatively, corneal stromal demarcation line depth was measured with the use of anterior segment optical coherence tomography by 2 independent observers. The rate of reepithelialization and endothelial cell density at a 3-month follow-up period were also evaluated.
Results:
No intraoperative or postoperative complications were observed in any of the patients. No statistically significant difference between the 2 observers' measurements was observed (P = 0.989). Mean corneal stromal demarcation line depth was 223 ± 32 μm (range, 159-265 μm). The mean endothelial cell density decreased from 2714 ± 174 preoperatively to 2671 ± 192 at 3 months postoperatively; however, this decrease was not statistically significant (P = 0.221).
Conclusions:
Corneal stromal demarcation line depth after a very high intensity 5-minute CXL protocol seems to be shallower than the standard Dresden protocol.
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