Long-term Effects and Prognostic Factors of Accelerated Cross-Linking with Retention Ring-assisted Riboflavin...

Area of Science:

• Ophthalmology
• Corneal Cross-linking
• Keratoconus Research

Background:

• Keratoconus is a progressive corneal ectasia leading to vision impairment.
• Standard corneal collagen cross-linking (CXL) aims to halt disease progression.
• Accelerated corneal collagen cross-linking (A-CXL) offers a potentially faster treatment option.

Purpose of the Study:

• To assess the long-term efficacy and safety of pulsed-light A-CXL with continuous riboflavin.
• To identify prognostic factors for halting keratoconus progression using A-CXL.
• To evaluate the impact of different riboflavin application times (5 vs. 10 minutes) on outcomes.

Main Methods:

• 37 eyes of 33 patients with progressive keratoconus underwent A-CXL with 5 or 10 minutes of continuous riboflavin.
• Evaluated successful halting rates and prognostic factors over time.
• Monitored changes in visual acuity, refractive errors, corneal topography, thickness, and endothelial cell density.

Main Results:

• Successful halting rates were 71% (5-min) and 89% (10-min) for A-CXL.
• Best-corrected visual acuity significantly improved in both groups.
• The 10-minute group showed significant reduction in maximum keratometry and corneal irregularity; the 5-minute group did not.

Conclusions:

• A-CXL with 10-minute continuous riboflavin is effective and safe for halting keratoconus progression.
• Higher baseline keratometric astigmatism predicted a greater post-treatment corneal flattening effect.
• Corneal thickness and endothelial cell density remained stable post-A-CXL.