&lt;p&gt;Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results&lt;/p&gt;

Cunha, Ana Maria; Sardinha, Tiago; Torrão, Luís; Moreira, Raúl; Falcão‐Reis, Fernando; Pinheiro-Costa, João

doi:10.2147/opth.s252940

Cited by 9 publications

(6 citation statements)

References 36 publications

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“…Studies comparing conventional and A-CXL overall show that the outcomes may be similar up to 3 years following CXL [13 ▪▪ ,14,15 ▪▪ ]. There is some concern that biomechanical stiffening effect may not be as significant or long lasting with accelerated protocols compared with conventional CXL [16 ▪ ]. In a 2019 meta-analysis of 1158 eyes comparing conventional and A-CXL, conventional CXL had better minimum keratometry values and deeper demarcation line depth, which may suggest long-term efficacy benefits with conventional CXL [17 ▪▪ ].…”

Section: Crosslinking: Accelerated Protocolmentioning

confidence: 99%

Update on corneal collagen crosslinking for ectasia

Pasha

Palazzolo²,

Prakash³

et al. 2021

Current Opinion in Ophthalmology

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Purpose of reviewCorneal collagen crosslinking (CXL) is a minimally invasive treatment that can stabilize corneal ectatic disorders including keratoconus, pellucid marginal degeneration, or postrefractive surgery ectasia. The benefits of CXL have been well documented. New research is focused on modifying current treatment protocols with the goals of maximizing corneal stability while also shortening overall procedure time. Recent findingsAccelerated CXL protocols have the goal of delivering the same ultraviolet A intensity as conventional protocols, but over a shorter time period. Accelerated protocols have shown success to date, but there are concerns for long-term corneal stability. Pulsed protocols may increase the long-term efficacy of the accelerated designs. In addition, transepithelial crosslinking protocols have been designed with the goal of reducing postoperative pain and lower the risk of infectious complications of epithelial-off conventional protocols. SummaryNewer CXL protocols attempt to make the procedure safer and more effective. Current research is promising, but long-term studies are essential to understand how the new protocols may affect corneal stability.

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Section: Crosslinking: Accelerated Protocolmentioning

confidence: 99%

Update on corneal collagen crosslinking for ectasia

Pasha

Palazzolo²,

Prakash³

et al. 2021

Current Opinion in Ophthalmology

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“…Increasing UV-A irradiation energy could potentially improve the efficacy of CXL treatment, and benzalkonium chloride could disrupt the tight junctions of the corneal epithelium [ 23 ]. A prior study used the conventional UV-A energy (5.4 J/cm 2 ) for Accelerated Transepithelial CXL and reported the same trend of kerametory changes not only at 1 year but also at 6, 18, and 24 months postoperatively [ 24 ]. The Accelerated Transepithelial CXL procedure had the lowest efficacy among the five CXL procedures 1 year postoperatively, as measured by K mean and K max values.…”

Section: Discussionmentioning

confidence: 99%

Independent-effect comparison of five crosslinking procedures for Progressive Keratoconus based on Keratometry and the ABCD Grading System using Generalized Estimating Equations (GEE)

et al. 2023

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Purpose Corneal collagen crosslinking (CXL) is an effective treatment for progressive keratoconus. Multiple CXL modalities are clinically available. The present study compared the 1 year outcomes of five types of CXL procedures for progressive keratoconus in a Chinese population using generalized estimating equations (GEE). Methods This retrospective study included 239 eyes in 171 patients with keratoconus who underwent CXL and were followed up for 1 year. Five CXL procedures were assessed, including Accelerated Transepithelial CXL, Iontophoresis CXL for 10 min, CXL plus phototherapeutic keratectomy (CXL-plus-PTK), High-Fluence Accelerated CXL, and Accelerated CXL. Patients treated with the Accelerated CXL procedure represented the reference group. Primary outcomes were visual acuity change, spherical equivalence, endothelial cell density, mean keratometry (Kmean), maximum keratometry (Kmax), minimum corneal thickness (MCT), and the ABCD Grading System, consisting of A (staging index for ARC; ARC = anterior radius of curvature), B (staging index for PRC, PRC = posterior radius of curvature), and C (staging index for MCT) values 1 year postoperatively compared to baseline. Secondary outcomes were corrected GEE comparisons from each procedure versus the Accelerated CXL group. Results The Accelerated Transepithelial CXL group had lower performance than the Accelerated CXL group according to Kmean and Kmax. The CXL-plus-PTK group performed significantly better than the reference group as reflected by Kmax (β = -0.935, P = 0.03). However, the CXL-plus-PTK group did not perform as well for B and C, and the Iontophoresis CXL group performed better for C. Conclusions The CXL-plus-PTK procedure was more effective than the Accelerated CXL procedure based on Kmax, and the Iontophoresis CXL procedure performed better on the C value based on the ABCD Grading System.

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“…Most studies in keratoconus have compared the results of different CCL methods such as standard cross-linking or epithelium-off CCL (epi-off CCL) and trans-epithelial corneal cross-linking (TE-CCL) (19,20,21). In recent years, several clinical trials have compared the therapeutic effects between the two methods (19,22,23), but studies on accelerated CCL are very limited.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Corneal Tomographic, Densitometric and Aberrometric Features Following Accelerated Corneal Cross-Linking in progressive keratoconus

Mohebbi

Samavat

Mohammadi

2022

Preprint

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Background: To evaluate the 12 months changes in tomographic, densitometric, and aberrometric parameters in keratoconic eyes after accelerated corneal cross-linking (CCL) and classify densitometric course in different stages of the keratoconus separately (Mild, moderate and severe).Methods: In a prospective observational study, 67 keratoconic eyes of 67 patients that underwent accelerated epithelium-off corneal cross-linking (9 mW/cm2 and 10 minutes) for treatment of progressive keratoconus were included. Corneal tomographic, densitometric, and aberrometric values obtained using the Pentacam HR were recorded at the baseline and 3, 6 and 12 months post-operatively. Result: One year after treatment, corrected distance visual acuity (CDVA) was improved and maximum keratometry, thinnest pachymetry, higher order and total Root Mean Square (RMS) were significantly decreased. (p<0.001) Corneal densitometry values showed a significant elevation 3 months post-surgery compared to baseline and then decreases to baseline values at 1 year. Only the Anterior 0-2 mm zone densitometry at third month was different between three groups. RMS at 1 year had correlation with Anterior 0-2 mm, Anterior 2-6 mm, total corneal 0-2 mm and total corneal 2-6 mm densitometry values at third month. Final CDVA at 12th month follow up correlated with the Anterior 0-2 mm corneal densitometry on third month.Conclusion: Anterior 0-2 mm zone densitometry at third month post accelerated CCL can be used to detect different staging of keratoconus. Due to correlation between final aberrometric and peak densitometric values in keratoconic eyes, peak densitometric values can be used as a prognostic factor for the final visual outcomes after accelerated CCL.

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<p>Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results</p>

Cited by 9 publications

References 36 publications

Update on corneal collagen crosslinking for ectasia

Update on corneal collagen crosslinking for ectasia

Independent-effect comparison of five crosslinking procedures for Progressive Keratoconus based on Keratometry and the ABCD Grading System using Generalized Estimating Equations (GEE)

Evaluation of Corneal Tomographic, Densitometric and Aberrometric Features Following Accelerated Corneal Cross-Linking in progressive keratoconus

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