Long-term results of accelerated and conventional corneal cross-linking
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ORIGINAL PAPER
Long-term results of accelerated and conventional corneal cross-linking Samara Barbara Marafon
. Sergio Kwitko . Diane Ruschel Marinho
Received: 1 March 2020 / Accepted: 2 June 2020 Ó Springer Nature B.V. 2020
Abstract Purpose The aim of this study is to compare the long-term follow-up outcomes of traditional and accelerated corneal cross-linking (CXL) for keratoconus. Methods This retrospective comparative cohort study included patients with keratoconus who underwent corneal cross-linking (CXL) between August 2008 and December 2016. Patients treated before August 2013 underwent the traditional Dresden protocol, and those treated subsequently received the accelerated protocol, i.e., 0.1% riboflavin soaking for 10 min, followed by pulsed UV-A irradiation at 30 mW/cm2 for 8 min, and a total irradiation power of 7.2 J/cm2. The primary outcome was the success rate in halting the disease progression. The postoperative changes in visual acuity, keratometry readings,
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10792-020-01462-w) contains supplementary material, which is available to authorized users. S. B. Marafon (&) S. Kwitko D. R. Marinho Department of Ophthalmology, Oftalmocentro, Porto Alegre, RS, Brazil e-mail: [email protected]
endothelial cell count and complications following accelerated CXL and conventional CXL were compared. Results This study evaluated 113 eyes over a mean follow-up period of 37.61 ± 16.34 months. It was found that 89.6% and 95.7% of the eyes were successfully treated with the traditional and accelerated protocols, respectively (p = 0.239). The corrected-distance visual acuity improved in both groups, but it was significantly better following the accelerated protocol (p = 0.037). Traditional protocol group had more postoperative complications than the accelerated group (8.9% versus 2%), although not reaching statistically significant difference (p = 0.142). There were no significant differences in the topographic (p = 0.122) and refractive (p = 0.570) outcomes. Conclusion Accelerated CXL and conventional CXL are both safe and effective, and the long-term follow-up showed that the accelerated protocol was similar to the standard one in terms of halting keratoconus and achieving visual outcomes. Because of its potential benefits, the accelerated protocol may be considered for the treatment of progressive keratoconus. Keywords Cross-linking Accelerated crosslinking Keratoconus Ectasia Cornea
S. B. Marafon S. Kwitko D. R. Marinho Programa de Po´s-Graduac¸a˜o em Cieˆncias Ciru´rgicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul e Hospital de Clı´nicas de Porto Alegre, Porto Alegre, RS, Brazil
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Int Ophthalmol
Introduction
Material and method
Keratoconus is a noninflammatory corneal disorder characterized by ectasia and visual impairment due to irregular astigmatism and ametropia. This disorder commonly presents as bilateral and asymmet
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