Standard and accelerated crosslinking protocols in keratoconus - differences and evolution at one year

Area of Science:

• Ophthalmology
• Corneal Ectasias
• Biomedical Engineering

Background:

• Keratoconus (KC) is a progressive bilateral corneal ectasia causing vision loss.
• Corneal crosslinking (CXL) is a treatment to halt KC progression.
• Epi-off CXL protocols, standard and accelerated, are used to treat KC.

Purpose of the Study:

• To compare the efficacy of standard versus accelerated epi-off corneal crosslinking (CXL) for keratoconus.
• To evaluate treatment outcomes after a one-year follow-up period.

Main Methods:

• 41 eyes with progressive keratoconus underwent either accelerated (Acc-CXL) or standard (Std-CXL) epi-off CXL.
• Parameters monitored included refraction, corneal topography (Kmax, Kmin), central corneal thickness (CCT), corneal resistance factor (CRF), and demarcation line depth.
• Measurements were repeated at 12 months post-intervention.

Main Results:

• Keratoconus progression was halted in all treated eyes.
• Both Acc-CXL and Std-CXL demonstrated significant improvements in spherical equivalent, Kmax, CCT, and CRF.
• No substantial differences in efficacy were observed between the two protocols, with demarcation line depths averaging ~280 micrometers.

Conclusions:

• Both standard and accelerated CXL are effective in halting keratoconus progression.
• Accelerated CXL provides a faster, more comfortable procedure with similar efficacy to the standard protocol.
• While both are safe and effective, the standard protocol may offer greater improvements in visual acuity and corneal flattening.