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Related Concept Videos

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Accelerators in concrete serve as admixtures to speed up the hardening process, enabling the concrete to achieve early strength faster. Although accelerators do not necessarily impact the time it takes concrete to set, they reduce this time in practice. A common accelerator is calcium chloride, which is particularly useful for hastening early strength development in cold weather or for rapid repair jobs that require quick heat generation after mixing.
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The importance of understanding acceleration spans our day-to-day experiences, as well as the vast reaches of outer space and the tiny world of subatomic physics. In everyday conversation, to accelerate means to speed up. For instance, we are familiar with the acceleration of our car; the harder we apply our foot to the gas pedal, the faster we accelerate. The greater the acceleration, the greater the change in velocity over a given time. Acceleration is widely seen in experimental physics. In...
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Acceleration is in the direction of the change in velocity, but it is not always in the direction of motion. When an object slows down, its acceleration is opposite to the direction of its motion. Although commonly referred to as deceleration, this causes confusion in our analysis as deceleration is not a vector, and does not point to a specific direction with respect to a coordinate system. Therefore, the term deceleration is not used. For example, when a subway train slows down, it...
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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Comparative Functional Outcomes After Corneal Crosslinking Using Standard, Accelerated, and Accelerated With Higher

Paul Z Lang1, Nikki L Hafezi2, Sumitra S Khandelwal3

  • 1Keck School of Medicine of USC, Los Angeles, CA.

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|January 26, 2019
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Summary
This summary is machine-generated.

Standard and accelerated corneal crosslinking (CXL) protocols for progressive keratoconus showed similar 12-month functional outcomes. Accelerated CXL achieved comparable results to standard CXL, with no significant differences in visual acuity or maximum keratometry.

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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.
  • Investigating accelerated CXL protocols may offer treatment efficiency without compromising outcomes.

Purpose of the Study:

  • To compare the 12-month functional outcomes of standard versus accelerated corneal crosslinking (CXL) protocols in patients with progressive keratoconus.
  • To evaluate the efficacy of different CXL protocols in improving visual acuity and corneal topography.

Main Methods:

  • Three epithelium-off CXL protocols were used: standard (S3/30-CXL), accelerated with equivalent irradiance (A9/10-CXL), and accelerated with increased irradiance (A30/4-CXL).
  • Efficacy was assessed at 12 months using Scheimpflug imaging, measuring changes in maximum keratometry (K Max), corrected distance visual acuity (CDVA), and other keratometric parameters.

Main Results:

  • All three CXL protocols demonstrated improvements in K Max and CDVA at 12 months.
  • No statistically significant differences in mean K Max or CDVA were observed between the standard and accelerated CXL groups.
  • Greater changes in specific keratoconus indices were noted with the standard protocol compared to accelerated protocols, though overall functional outcomes were similar.

Conclusions:

  • Standard and accelerated CXL protocols yield comparable 12-month functional outcomes for progressive keratoconus.
  • While some keratoconus indices showed differential changes, both standard and accelerated CXL effectively stabilize and improve visual parameters.
  • Correlations between changes in keratometric variables and CDVA were generally poor, with K Mean, central keratoconus index, and anterior asphericity showing better association with CDVA than K Max.