ISSN : 2146-3123
E-ISSN : 2146-3131

Comparison of Two Different Accelerated Corneal Cross-linking Procedure Outcomes in Patients with Keratoconus
Kemal Özülken1, Gözde Aksoy Aydemir2, Emre Aydemir2, Hasan Kızıltoprak3, Erdem Yüksel4
1Department of Ophthalmology, TOBB ETU School of Medicine, Ankara, Turkey
2Clinic of Ophthalmology, Adıyaman University Training and Research Hospital, Adıyaman, Turkey
3Clinic of Ophthalmology, Bingöl Maternity and Child Diseases Hospital, Bingöl, Turkey
4Department of Ophthalmology, Kastamonu University School of Medicine, Kastamanonu, Turkey
DOI : 10.4274/balkanmedj.galenos.2020.2019.8.45
Pages : 131-137

Abstract

Background: Corneal cross-linking treatment is the unique treatment method that can cease the progression of keratoconus disease. Because of the long duration of conventional treatment, accelerated cross-linking treatment methods are being developed.
Aims: To compare two different accelerated corneal cross-linking protocols in terms of postoperative visual acuity and topographic findings (higher-order aberrations and keratometry values).
Study Design: Retrospective comparative study.
Methods: Sixty-five eyes of 43 patients (30 men and 13 women) who underwent two different accelerated corneal cross-linking protocols (10 min, 9 mW/cm2 and 5 min, 18 mW/cm2) for progressive keratoconus were retrospectively analyzed. Patients were divided into two groups according to the accelerated corneal cross-linking treatment protocol: group 1 (10 min, 9 mW/cm2, 32 eyes of 21 patients) and group 2 (5 min, 18 mW/cm2, 33 eyes of 22 patients). Uncorrected visual acuity and best-corrected visual acuity values and topographic findings (central corneal thickness and flat and steep keratometry values) were recorded preoperatively and 6 months after corneal cross-linking treatment. High-order aberration values measured with Pentacam preoperatively and 6 months after corneal cross-linking were also recorded.
Results: In both groups, a significant improvement was detected in the uncorrected visual acuity and best-corrected visual acuity levels preoperatively and 6 months postoperatively (group 1: p=0.001, p=0.001 and group 2: p=0.001, p=0.001, respectively). In addition, central corneal thickness values decreased significantly in both groups (p=0.006 and 0.001). Trefoil values showed no significant difference preoperatively and 6 months postoperatively in group 1 (p=0.160 and 0.620, respectively). In groups 1 and 2, coma values were found to decrease significantly in the 6th postoperative month compared with preoperative values (p=0.001 and 0.020, respectively). There was no significant difference between preoperative and 6th month postoperative horizontal and vertical trefoil values in both groups (p=0.850 and 0.140, respectively). There was no significant difference between the two groups in terms of preoperative and 6th month postoperative higher-order aberrations, refractive errors, keratometry values, and uncorrected visual acuity and best-corrected visual acuity levels.
Conclusion: Both accelerated corneal cross-linking procedures provide similar improvement in topographic findings, coma values ​​and visual acuity.

Keywords : Accelarated cross-linking, coma, corneal cross-linkin, cxl, higher-order aberations, keratoconus
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