Efficacy of different accelerated corneal crosslinking protocols for progressive keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive corneal ectasia leading to vision impairment.
• Corneal crosslinking (CXL) is a standard treatment to halt keratoconus progression.
• Accelerated CXL protocols aim to reduce treatment time while maintaining efficacy.

Purpose of the Study:

• To evaluate and compare the efficacy of different accelerated corneal crosslinking (CXL) protocols in patients with progressive keratoconus.
• To assess visual acuity and topographic changes following various accelerated CXL treatments.

Main Methods:

• A retrospective case series involving 134 eyes with progressive keratoconus.
• Patients underwent conventional CXL, 9 mW accelerated CXL (10 minutes), 30 mW continuous-light accelerated CXL (4 minutes), or 30 mW pulsed-light accelerated CXL (8 minutes).
• Outcomes measured included uncorrected and corrected distance visual acuity (UDVA, CDVA) and keratometric readings.

Main Results:

• Both conventional CXL and 9 mW accelerated CXL significantly improved UDVA and CDVA.
• All keratometric parameters improved significantly with conventional CXL and 9 mW accelerated CXL.
• 30 mW continuous-light accelerated CXL showed improvement only in CDVA.
• 30 mW pulsed-light accelerated CXL did not yield significant changes in visual acuity or keratometry.

Conclusions:

• While 30 mW accelerated CXL protocols appear effective in stabilizing keratoconus progression, they demonstrate limited topographic improvement compared to conventional or 9 mW accelerated CXL.
• The 9 mW accelerated CXL protocol shows promise for both visual and topographic enhancement in keratoconus patients.