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Updated: Jul 31, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
07:29

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis

Published on: November 12, 2015

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A comparison of conventional and accelerated corneal crosslinking: corneal epithelial remodeling and in vivo confocal

Sezer Hacıağaoğlu1, Semra Akkaya Turhan2, Ebru Toker3

  • 1Department of Ophthalmology, Bahçeşehir University, Sahrayıcedit Mah. Batman Sk. No:66, 34734 Kadıköy, Istanbul, Turkey. drsezerh@hotmail.com.

International Ophthalmology
|February 16, 2024
PubMed
Abstract

Insights

Both conventional and accelerated corneal crosslinking (CXL) effectively treat progressive keratoconus. Accelerated CXL shows faster subbasal nerve regeneration compared to conventional CXL.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Regenerative Medicine

Background:

  • Keratoconus is a progressive corneal ectasia leading to vision impairment.
  • Corneal crosslinking (CXL) aims to halt keratoconus progression by strengthening corneal tissue.
  • Evaluating both conventional and accelerated CXL methods is crucial for optimizing treatment outcomes.

Purpose of the Study:

  • To compare the efficacy of conventional corneal crosslinking (C-CXL) and accelerated corneal crosslinking (A-CXL) in progressive keratoconus.
  • To assess the impact of CXL on visual acuity, corneal topography, and epithelial thickness.
  • To investigate subbasal nerve morphology changes following CXL using in vivo confocal microscopy (IVCCM).

Main Methods:

  • A prospective, randomized study involving patients with progressive keratoconus.
  • Patients received either conventional CXL (3 mW/cm², 30 min) or accelerated CXL (9 mW/cm², 10 min).
  • Evaluations included visual acuity, keratometry, epithelial thickness, and subbasal nerve density at baseline and up to 6 months post-procedure.

Main Results:

  • Both CXL methods significantly improved keratometric values at 6 months.
  • Epithelial thickness generally reduced post-CXL, with improved uniformity.
  • Subbasal nerve density decreased at 1 month but recovered to baseline in the A-CXL group by 6 months, unlike the C-CXL group.

Conclusions:

  • Conventional and accelerated CXL are effective in halting keratoconus progression.
  • Corneal epithelial irregularity shows slight improvement after CXL.
  • Accelerated CXL demonstrates a faster regeneration of subbasal nerves compared to conventional CXL.
Keywords:
Accelerated crosslinkingConventional crosslinkingEpithelial thickness mappingKeratoconusSubbasal nerve analysis

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