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

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Summary

Accelerated corneal cross-linking (A-CXL) using pulsed light (pl-CXL) or continuous light (cl-CXL) showed similar effectiveness in treating keratoconus. Both methods achieved comparable corneal treatment depth and long-term visual stability.

Keywords:
corneal cross-linkingdemarcation line anterior segment OCTkeratoconuspulsed light corneal cross-linkingultraviolet A corneal cross-linking

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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.