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Updated: Feb 10, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Influence of the beam profile crosslinking setting on changes in corneal topography and tomography in progressive
Robert Herber1, Kathleen S Kunert1, Věra Veliká1
1From the Department of Ophthalmology (Herber, Spoerl, Pillunat, Raiskup), University Hospital Carl Gustav Carus, Dresden, and the Ernst-Abbe-University of Applied Sciences (Kunert), Jena, Germany; Department of Ophthalmology (Veliká, Raiskup), University Hospital Hradec Králové, Charles University, Prague, Czech Republic.
Purpose:
To evaluate the effect of accelerated corneal crosslinking (CXL) with a "higher peripheral intensity" profile setting compared with a standard "top hat" profile setting performed using different CXL systems.
Setting:
Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany.
Design:
Retrospective case series.
Methods:
Eyes from patients with progressive keratoconus were included. Group 1 included eyes treated with the higher peripheral intensity profile. Group 2 included eyes treated with the top hat profile. Accelerated CXL was performed based on the modified Dresden protocol (9 mW/cm2, 10 minutes). Corneal-topography and tomography are characterized using the Pentacam Scheimpflug system.
Results:
The study comprised 45 eyes (25 eyes in Group 1, 20 eyes in Group 2) from 45 patients. The keratometry (K) at the apex (maximum K) decreased significantly from 54.95 diopters (D) ± 6.73 (SD) to 53.21 ± 6.05 D for Group 1 (P < .001) and from 57.29 ± 7.16 D to 56.48 ± 6.88 D for Group 2 (P = .01). In Group 1, flat K (K1) and steep K (K2) decreased significantly after treatment (P < .05). The thinnest corneal thickness decreased significantly by -17.5 ± 21.9 μm (P = .001) in Group 1. In Group 2, no significant flattening was observed in K1 and K2 (P > .05), and the thinnest corneal thickness showed a slight but not significant thinning (P = .097).
Conclusions:
In Group 1 (the higher peripheral intensity group), the corneal topographic and tomographic parameters improved significantly after accelerated CXL. The higher peripheral intensity profile effect on keratoconic cornea flattening seemed to be more pronounced compared with the top hat profile.
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