Comparison Between Pulsed and Continuous Accelerated Corneal Cross-Linking Protocols.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Biomedical Engineering

Background:

• Keratoconus (KC) is a progressive corneal ectasia requiring effective management.
• Accelerated corneal cross-linking (A-CXL) is an established treatment for progressive KC.
• Comparing different A-CXL protocols is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To compare the efficacy of two accelerated corneal cross-linking (A-CXL) protocols in managing keratoconus (KC).
• To evaluate the extent of corneal treatment achieved by pulsed light A-CXL (pl-CXL) versus continuous light A-CXL (cl-CXL).
• To assess the postoperative stability of refractive and keratometric outcomes.

Main Methods:

• Retrospective comparative study of mild to moderate, progressive KC patients.
• Group 1: 103 eyes (62 patients) received pl-CXL (30 mW/cm², 4 min).
• Group 2: 87 eyes (51 patients) received cl-CXL (12 mW/cm², 10 min).
• Demarcation line depth (DD) measured by OCT; refractive and keratometric stability assessed over one year.

Main Results:

• No statistically significant differences in preoperative corneal or epithelial thickness between groups.
• Demarcation line depths (central, peripheral, max, min) were comparable between pl-CXL and cl-CXL groups.
• Both groups demonstrated statistically insignificant differences in refractive and keratometric outcomes, indicating stability.

Conclusions:

• Longer duration continuous light A-CXL (cl-CXL) appears as effective as pulsed light A-CXL (pl-CXL).
• Both protocols achieve comparable corneal tissue penetration and postoperative stability.
• Further research may explore optimal parameters for A-CXL in keratoconus management.