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Customized cross-linking yields stronger corneal flattening
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Customized corneal cross-linking compared well with standard cross-linking in terms of visual acuity but yielded stronger corneal flattening and faster epithelial healing, according to a study.
The prospective study included 40 eyes of 40 patients with progressive primary keratoconus; 20 eyes underwent customized cross-linking, and 20 eyes underwent standard cross-linking.
Energy fluence for customized irradiation patterns, centered on the maximum of the posterior float, was 9 mW/cm2, with total energy levels ranging from 5.4 J/cm2 to 10 J/cm2. Homogenous irradiation was used in the control group, with a fluence of 9 mW/cm2 and a total energy of 5.4 J/cm2.
At 1 year postoperatively, best corrected logMAR visual acuity was –0.07 in the customized group and –0.04 in the standard group; the difference was not significant.
Epithelial healing time was 2.56 days in the customized group and 3.19 days in the standard group; the difference was statistically significant (P = .02).
Two of 19 eyes in the standard group and seven of 19 eyes in the customized group had flattening of 2 D or more; the between-group difference was statistically significant (P = .03).
The regularization index, defined as maximal steepening plus maximal flattening at 1 year compared with preoperatively, was 5.2 D in the customized group and 4.1 D in the standard group; the difference was statistically significant (P = .03). – by Matt Hasson
Disclosure: The authors report no relevant financial disclosures.
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Seiler TG, et al. Am J Ophthalmol. 2016;doi:10.1016/j.ajo.2016.02.029.
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