Comparative Evaluation of Anterior Segment Optical Coherence Tomography Findings Following Accelerated Corneal...

Area of Science:

• Ophthalmology
• Corneal Science
• Biomedical Engineering

Background:

• Progressive keratoconus is a degenerative corneal condition requiring effective treatment.
• Corneal crosslinking (CXL) is a standard treatment to halt keratoconus progression.
• Accelerated CXL (ACXL) offers potentially shorter treatment times.

Purpose of the Study:

• To compare the impact of various riboflavin formulations and soaking times on anterior segment optical coherence tomography (AS-OCT) findings after ACXL.
• To evaluate the efficacy of ACXL at 9 mW/cm² in patients with progressive keratoconus.

Main Methods:

• A prospective study randomized 104 patients with progressive keratoconus into four groups.
• Groups received ACXL with either HPMC-based riboflavin (10 or 20 min soak) or dextran-based riboflavin (30 min soak), followed by 9 mW/cm² UVA irradiation.
• A control group underwent conventional CXL (CCXL) using the Dresden protocol; AS-OCT was performed at 1 month, and clinical outcomes assessed at 12 months.

Main Results:

• HPMC-based riboflavin groups showed deep demarcation lines (DLD) similar to CCXL.
• Dextran-based riboflavin resulted in a significantly shallower DLD compared to other groups (p < 0.01).
• No significant differences in visual, refractive, keratometric, or tomographic outcomes were observed among groups at 12 months postoperatively.

Conclusions:

• While ACXL with HPMC-based riboflavin yielded structural results comparable to CCXL, dextran-based riboflavin led to shallower DLDs.
• Despite observed differences in corneal remodeling, all ACXL and CCXL groups demonstrated similar clinical efficacy at one-year follow-up.
• Further research with larger cohorts and longer follow-up is needed to correlate AS-OCT characteristics with ACXL efficacy.