Accelerated CXL Versus Accelerated Contact-Lens Assisted CXL Treatment for Progressive Keratoconus-A 3-Year...

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus management often requires corneal cross-linking.
• Thin corneas (<400 µm) present challenges for standard A-CXL.
• Contact lens-assisted corneal cross-linking (A-CACXL) is an alternative for thin corneas.

Purpose of the Study:

• Compare long-term clinical and tomographic outcomes of A-CXL and A-CACXL.
• Evaluate A-CACXL's efficacy in patients with thin corneas.
• Assess keratoconus progression after A-CACXL.

Main Methods:

• Retrospective cohort study (2015-2018) comparing A-CXL (n=32) and A-CACXL (n=30).
• Patients had minimum corneal thickness ≥400 µm (A-CXL) or <400 µm (A-CACXL).
• 3-year follow-up for clinical and tomographic data.

Main Results:

• Both groups showed significant improvement in best-corrected visual acuity.
• Postoperative tomographic parameters (Kmax, Kmean, astigmatism) were similar between groups.
• Keratoconus progression halted in 87% (A-CXL) and 73% (A-CACXL) of eyes.

Conclusions:

• A-CACXL is a safe and effective treatment for keratoconus in thin corneas.
• Long-term outcomes of A-CACXL are comparable to A-CXL in suitable patients.
• A-CACXL expands cross-linking options for challenging keratoconus cases.