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Accelerated (9-mW/cm2) Corneal Collagen Crosslinking for KeratoconusA 1-Year Follow-up

Elbaz, Uri MD; Shen, Carl BMSc; Lichtinger, Alejandro MD; Zauberman, Noa A. MD, MHA; Goldich, Yakov MD; Chan, Clara C. MD, FRCSC; Slomovic, Allan R. MD, FRCSC; Rootman, David S. MD, FRCSC

doi: 10.1097/ICO.0000000000000154
Clinical Science

Purpose: The aim of this study was to assess the efficacy of accelerated crosslinking (irradiance of 9 mW/cm2; 10 minutes) in keratoconus-affected eyes through topographical, visual, and refractive end points.

Methods: Mild-moderate keratoconus-affected eyes that underwent accelerated corneal collagen crosslinking (CXL) treatment and had 6 and 12 months of follow-up were reviewed retrospectively. Data regarding uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), and computerized corneal topography data before surgery and post-CXL treatment were extracted and analyzed.

Results: Sixteen eyes of 14 patients were included in the study. The mean patient age was 24.9 ± 5.8 years (range: 17.1–38.3 years). No statistically significant changes were found in the mean CDVA, mean refractive cylinder, or mean manifest refraction spherical equivalent at either time point. There was a gain of 0.13 logarithm of the minimum angle of resolution lines in the mean UDVA (P = 0.012) at 12 months. All corneal parameters including Ksteep, Kflat, average K (Km), corneal astigmatism (Kcyl), and maximal curvature reading at the corneal apex (Kmax) were stable at 6 and 12 months in all patients. No complications were observed during the follow-up period.

Conclusions: Accelerated corneal CXL is effective in stabilizing topographic parameters after 12 months of follow-up in mild-moderate keratoconus-affected corneas. Improvement in the UDVA and stabilization of all tested corneal parameters were noted after the treatment. However, a longer follow-up with larger cohorts is necessary to validate these findings.

Department of Ophthalmology, Toronto Western Hospital, University of Toronto, Yonge Eglinton Laser Eye Center, Toronto, Canada.

Reprints: Uri Elbaz, MD, Department of Ophthalmology, Toronto Western Hospital, University of Toronto, 399 Bathurst St, 6 East Wing, Toronto, Ontario, Canada (e-mail:

U. Elbaz and C. Shen contributed equally to this work.

The authors have no funding or conflicts of interest to disclose.

U. Elbaz is a recipient of the Schwartz Reisman Fellowship, Toronto, ON, Canada, for 2012-2013.

Received November 05, 2013

Accepted April 13, 2014

© 2014 by Lippincott Williams & Wilkins.