Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

Eye and Vision

Ashraf Armia Balamoun¹  Frederik Raiskup²  Giuseppe Giannaccare³  Simone Alex Bagaglia⁴  Cosimo Mazzotta⁵  Emilio A Torres-Netto⁶  Farhad Hafezi⁷ 

[1] Ashraf Armia Eye Clinic and Al Watany Eye Hospital, Watany Research and Development Centre, Cairo, Egypt;Department of Ophthalmology, C.G. Carus University Hospital, Dresden, Germany;Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy;Departmental Ophthalmology Unit, USL Toscana Sud-Est, Campostaggia, Siena, Italy;Departmental Ophthalmology Unit, USL Toscana Sud-Est, Campostaggia, Siena, Italy;Siena Crosslinking Center, 53035, Monteriggioni, Siena, Italy;ELZA Institute, Dietikon, Switzerland;Medical Faculty, University of Geneva, Geneva, Switzerland;Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil;ELZA Institute, Dietikon, Switzerland;Medical Faculty, University of Geneva, Geneva, Switzerland;Roski Eye Institute, University of Southern California, Los Angeles, CA, USA;Department of Ophthalmology, University of Wenzhou, Wenzhou, China;

关键词: Crosslinking;    Keratoconus;    Accelerated crosslinking;    Epi-off;    Dresden accelerated protocol;    9 mW crosslinking;    CXL;    ACXL;   

DOI  :  10.1186/s40662-021-00240-8

来源: Springer

【 摘 要 】

PurposeTo assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years.MethodsThe prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed.ResultsUDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm.ConclusionThe 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be  the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

【 授权许可】

CC BY