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Accelerated cross-linking protocol may be less effective for topographic flattening
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Despite a shorter irradiation time and a higher UV dose, the accelerated corneal cross-linking protocol is less effective for topographic flattening when compared with the standard Dresden protocol for keratoconus, a study found.
Researchers compared the results of the accelerated cross-linking protocol and the conventional Dresden protocol in 28 eyes with primary keratoconus. Visual acuity, keratometric values and topographic parameters were evaluated.
Fifteen eyes in group 1 received the standard Dresden protocol, and 13 eyes in group 2 received the accelerated protocol. The standard Dresden protocol consisted of 0.1% riboflavin with 20% dextran 500 applied every 3 minutes for 30 minutes, for a dose of 5.4 J/cm2. The accelerated protocol consisted of 0.1% riboflavin with hydroxypropyl methylcellulose applied every 2 minutes for 10 minutes, for a dose of 6.6 J/cm2.
There were no statistically significant differences between either group in terms of visual acuity and refractive error. The steep keratometry value had a statistically significant decrease in group 1 of 0.55 ± 0.89 D compared with an increase in group 2 of 0.32 ± 0.86 D (P = .015). The mean keratometry value decreased by 0.44 ± 0.63 D in group 1 and increased by 0.11 ± 0.51 D in group 2 (P = .019).
“Although the accelerated protocol has advantages of reduced treatment time and less reduction in the postoperative corneal thickness, the conventional Dresden protocol had a better therapeutic effect of corneal flattening and should remain the standard procedure for keratoconus,” the researchers wrote. – by Robert Linnehan
Disclosure: The authors report no relevant financial disclosures.
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Choi M, et al. Cornea. 2017;doi:10.1097/ICO.0000000000001165.
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