Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus: 1-year results

To investigate the safety and efficacy of a new protocol for transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus treatment.

There were 26 patients (26 eyes) diagnosed with keratoconus enrolled in the study and treated with transepithelial accelerated corneal collagen cross-linking. The corneas were irradiated using UVA light for 5 min and 20 s with 45 mW/cm² irradiance and pulsed illumination (1:1). The follow-up examinations were performed at 1 day, 1 month, 3 months, 6 months, and 1 year postoperatively. At each follow-up, the patients received a complete ophthalmologic examination that included visual acuity, manifest refraction, corneal topography, endothelial cell density, and ORA.

The operations were uneventful, and there were no complications during follow-up. At 1 year after the procedure, the uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of the treated eyes were significantly improved compared to the pretreatment values (P = 0.012, 0.041, respectively). Additionally, 65.4% of eyes gained at least 1 line in CDVA, and 42.3% of eyes showed a reduction in at least 0.5D in astigmatism. The maximum keratometry (K _max), corneal thickness, corneal endothelial cell density and corneal biomechanics were stable at each visit.

Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability was safe for keratoconus treatment and partially prevented disease progression. Therefore, further studies with large patient cohorts and longer follow-up periods are recommended.