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

  • Ophthalmology
  • Corneal diseases
  • Refractive surgery

Background:

  • Keratoconus is a progressive corneal ectasia.
  • Corneal crosslinking (CXL) aims to halt keratoconus progression.
  • Predicting post-CXL progression is crucial for patient management.

Purpose of the Study:

  • Identify factors predicting keratoconus progression after CXL.
  • Analyze tomographic, pachymetric, and patient-specific data.
  • Correlate preoperative and postoperative outcomes.

Main Methods:

  • Retrospective analysis of 147 eyes from 123 keratoconus patients.
  • Conventional epithelium-off CXL (3 mW/cm² for 30 min).
  • Linear Mixed Model and Cox regression for outcome prediction.

Main Results:

  • Atopic dermatitis showed a trend towards higher Kmax progression post-CXL.
  • Higher preoperative Kmax progression and baseline Kmax were associated with reduced annual progression.
  • Higher baseline Kmax trended with increased risk of isolated progression events.

Conclusions:

  • Atopic dermatitis may be a risk factor for post-CXL keratoconus progression.
  • Preoperative progression rate and baseline Kmax influence long-term outcomes.
  • Dual analytical approaches are vital for interpreting post-CXL results.