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Conventional, accelerated cross-linking yield similar outcomes
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Conventional and accelerated corneal cross-linking had comparable anatomic and visual outcomes in treating keratoconus, according to study findings.
The prospective, randomized clinical trial included 153 eyes of 153 patients with progressive keratoconus; 76 eyes underwent conventional cross-linking (CXL) and 77 eyes underwent accelerated cross-linking. Mean patient age was 22.3 years in the conventional CXL group and 22.6 years in the accelerated CXL group.
Outcome measures included uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, maximum keratometry, endothelial cell density, anterior and posterior stromal keratocyte density, and sub-basal nerve density. Patients were examined preoperatively and 1, 3, 6, 12 and 15 months postoperatively.
Mean sphere decreased significantly, from –4.3 D to –2.9 D in the conventional CXL group and from –4.8 D to –3.5 D in the accelerated CXL group, according to the researchers.
Mean cylinder also decreased significantly, from –5.9 D to –4.6 D in the conventional CXL group and from –4.6 D to –3.2 D in the accelerated CXL group at 15 months.
Decreases in sphere and cylinder were statistically similar in both groups. UDVA and CDVA improved significantly and were similar in both groups at 15 months, according to the researchers.
Maximum keratometry increased slightly at 1 month but subsequently diminished in both groups.
Both groups had similar endothelial cell density at 15 months.
The researchers also observed a significant reduction in anterior keratocyte density and sub-basal nerve density at 1 month in both groups; however, both variables decreased more in the conventional group at all follow-up points up to 1 year.
Disclosure: The authors have no relevant financial disclosures.
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