Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus: 1-year results
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To investigate the safety and efficacy of a new protocol for transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus treatment.
There were 26 patients (26 eyes) diagnosed with keratoconus enrolled in the study and treated with transepithelial accelerated corneal collagen cross-linking. The corneas were irradiated using UVA light for 5 min and 20 s with 45 mW/cm2 irradiance and pulsed illumination (1:1). The follow-up examinations were performed at 1 day, 1 month, 3 months, 6 months, and 1 year postoperatively. At each follow-up, the patients received a complete ophthalmologic examination that included visual acuity, manifest refraction, corneal topography, endothelial cell density, and ORA.
The operations were uneventful, and there were no complications during follow-up. At 1 year after the procedure, the uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of the treated eyes were significantly improved compared to the pretreatment values (P = 0.012, 0.041, respectively). Additionally, 65.4% of eyes gained at least 1 line in CDVA, and 42.3% of eyes showed a reduction in at least 0.5D in astigmatism. The maximum keratometry (K max), corneal thickness, corneal endothelial cell density and corneal biomechanics were stable at each visit.
Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability was safe for keratoconus treatment and partially prevented disease progression. Therefore, further studies with large patient cohorts and longer follow-up periods are recommended.
KeywordsTransepithelial accelerated corneal collagen cross-linking Keratoconus Pulsed illumination Safety Efficacy
This study was funded by the National Natural Science Foundation of China (Grant No. 81570879), the National Natural Science Foundation of China for Young Scholars (Grant No. 81600762). The sponsors and funding organizations had no role in the design or conduct of this research.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of Ethical Committee of the Fudan University EENT Hospital Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.