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Comparison of the Conventional Dresden Protocol and Accelerated Protocol With Higher Ultraviolet Intensity in Corneal Collagen Cross-Linking for Keratoconus

Authors
 Choi Moonjung  ;  Kim Jiwon  ;  Kim Eung Kweon  ;  Seo Kyoung Yul  ;  Kim Tae-im 
Citation
 Cornea, Vol.36(5) : 523-529, 2017 
Journal Title
 Cornea 
ISSN
 0277-3740 
Issue Date
2017
MeSH
Adult ; Collagen/metabolism ; Cornea/drug effects ; Cornea/metabolism ; Corneal Stroma/metabolism ; Corneal Topography ; Cross-Linking Reagents/therapeutic use* ; Female ; Humans ; Keratoconus/drug therapy* ; Keratoconus/metabolism ; Keratoconus/physiopathology ; Male ; Photochemotherapy/methods* ; Photosensitizing Agents/therapeutic use* ; Prospective Studies ; Refraction, Ocular ; Riboflavin/therapeutic use* ; Ultraviolet Rays* ; Visual Acuity ; Young Adult
Abstract
PURPOSE: To compare the accelerated corneal cross-linking (CXL) protocol and the conventional Dresden protocol in patients with keratoconus in terms of visual acuity, keratometric values, and topographic parameters. METHODS: Twenty-eight eyes of 25 patients with primary keratoconus were divided into 2 groups; 15 eyes in group 1 received CXL under the standard Dresden protocol (3 mW/cm for 30 min, dose 5.4 J/cm) and 13 eyes in group 2 were treated with the accelerated protocol (30 mW/cm for 3 min 40 s, dose 6.6 J/cm). Visual acuity, refractive error, keratometry values obtained by both Pentacam and Auto Kerato-Refractometer, corneal thickness, and topometric indexes were compared 6 months postoperatively. RESULTS: The visual acuity improved significantly from 0.17 ± 0.16 to 0.08 ± 0.09 logarithm of the minimum angle of resolution in group 1 (P = 0.009). The cylindrical refractive error improved in both groups (P = 0.05 in group 1 and P = 0.011 in group 2), and the spherical equivalent increased in group 1 (P = 0.021). In group 1, the maximum keratometry value decreased by 0.55 ± 0.89 diopters (P = 0.03), and the mean keratometry value decreased by 0.44 ± 0.63 diopters (P = 0.017), whereas the changes in visual acuity, spherical and spherical equivalent refractive errors, and keratometric values in group 2 were not statistically significant. The corneal thickness at the apex decreased significantly in group 1 (P = 0.001), but the change was not significant in group 2. CONCLUSIONS: Despite a higher UV dose (6.6 J/cm), accelerated CXL with higher UV intensity and reduced irradiation time showed a smaller topographic flattening effect than did the conventional Dresden protocol in primary keratoconus with documented progression.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00003226-201705000-00001&LSLINK=80&D=ovft
DOI
10.1097/ICO.0000000000001165
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
김응권(Kim, Eung Kweon) ORCID logo https://orcid.org/0000-0002-1453-8042
김지원(Kim, Ji Won)
김태임(Kim, Tae Im) ORCID logo https://orcid.org/0000-0001-6414-3842
서경률(Seo, Kyuong Yul) ORCID logo https://orcid.org/0000-0002-9855-1980
최문정(Choi, Moonjung)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160537
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