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Title: Conventional versus accelerated collagen cross-linking for keratoconus: A comparison of visual, refractive, topographic and biomechanical outcomes
Authors: Woo, J.H
Iyer, J.V
Lim, L 
Hla, M.H
Mehta, J.S 
Chan, C.M.L
Tan, D.T.H 
Keywords: collagen
vibeX rapid
best corrected visual acuity
cell density
cell loss
comparative study
controlled study
cornea thickness
corneal hysteresis
cross linking
cylinder equivalent
eye refraction
follow up
major clinical study
outcome assessment
postoperative period
priority journal
prospective study
R factor
scar formation
spherical equivalent
visual evoked potential
visual system parameters
Issue Date: 2017
Citation: Woo, J.H, Iyer, J.V, Lim, L, Hla, M.H, Mehta, J.S, Chan, C.M.L, Tan, D.T.H (2017). Conventional versus accelerated collagen cross-linking for keratoconus: A comparison of visual, refractive, topographic and biomechanical outcomes. Open Ophthalmology Journal 11 : 262-272. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Objective: The aim was to compare the visual, refractive, topographic and biomechanical outcomes in patients with progressive keratoconus treated with either conventional or accelerated crosslinking at one year follow up. Methods: It is a prospective, non-randomised interventional study of 76 patients who underwent conventional (CXL; 3mW/cm2 for 30 minutes) or accelerated cross linking (KXL; 30mW/cm2 for 4 minutes) for progressive keratoconus. Baseline and postoperative visual acuity, manifest refraction, corneal topography, pachymetry, endothelial cell density and biomechanical parameters of corneal hysteresis and corneal resistance factor were evaluated and compared. Results: The 2 groups were comparable in terms of uncorrected and best corrected visual acuity and spherical equivalent. Both groups showed no significant increase in K1, K2 and Kmean from baseline at 12 months. There was also no difference between the CXL and KXL group for postoperative corneal topography as well as central and minimal pachymetry up to 12 months. There was a significant increase in both corneal hysteresis (0.62mm Hg, P=0.04) and corneal resistance factor (0.91mm Hg, P=0.003) in the KXL group at 12 months but not in the CXL group. There was no significant endothelial cell loss throughout follow up in both the groups. Conclusion: We have established comparability of the 2 protocols in stabilizing the progression of keratoconus. Our findings also suggested an added biomechanical advantage of accelerated crosslinking at 1 year follow up. @ 2017 Woo et al.
Source Title: Open Ophthalmology Journal
ISSN: 18743641
DOI: 10.2174/1874364101711010262
Rights: Attribution 4.0 International
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