The Independent Effect of Various Cross-Linking Treatment Modalities on Treatment Effectiveness in Keratoconus

Purpose: To investigate the 1-year outcomes of using various corneal cross-linking (CXL) techniques for treating keratoconus. Methods: Setting: This is a prospective longitudinal cohort study performed at a tertiary academic medical center. Patient population: Six hundred seventy eyes of 461 patients with progressive keratoconus who underwent CXL were followed up for 1 year. Intervention: Eight combinations of CXL modalities were assessed, including 2 different CXL techniques (transepithelial or epithelium-off), 7 riboflavin formulations, and 2 ultraviolet-A protocols (conventional 3 mW/cm2 or accelerated 9 mW/cm2). Patients treated using the Dresden protocol were used as the reference group.Main outcome measures: Primary outcomes were maximum keratometry and mean keratometry 1 year after treatment. Multivariable linear regression was used which provides β coefficients (β). Secondary outcomes were uncorrected and corrected distance visual acuity, manifest refractive spherical equivalent, and corneal thickness 1 year after treatment. Results: Four treatment modalities differed significantly from the reference group regarding both maximum keratometry and mean keratometry: the transepithelial CXL (TE-CXL) group (β = 1.422; P = 0.001), 1 riboflavin formulation (Meran β = 1.210; P = 0.02), and both the 9 mW/cm2 protocols (Vibex Rapid β = 1.751; P
Source: Cornea - Category: Opthalmology Tags: Clinical Science Source Type: research