This is one of many studies published / to be published on corneal collagen cross-linking that has a treatment time of 10 minutes compared to the previous Dresden protocol of 30 minutes to halt progression of keratoconus. Much has changed since the original Dresden protocol including the accelerated treatment protocol. Ex-vivo porcine and in-vivo confocal studies have shown that equivalent biomechanical changes in porcine corneas are achieved in the accelerated treatment protocol. The retrospective study had inclusion criteria very different to National Institute of Health & Care Excellence (NICE) guidance in the UK, e.g. patients with subjective deterioration in vision. Only cases with mild-moderate (grade I-II Amsler-Krumeich classification) were included. Progression was defined as a decrease in visual acuity of at least one line (logMAR), increase in corneal steepness of one dioptre (steepest keratometry) over previous six months and >1D change in prescription of glasses / contact lenses over preceding two years. Sixteen eyes of 14 patients (three females, 11 males). No statistically significant difference was found in the mean corrected distance visual acuity (CDVA), mean refractive cylinder, mean manifest refraction spherical equivalent (SE), at six or 12 months post treatment. Corneal parameters K steep, K flat, corneal astigmatism, K mean and K maximum at the corneal apex were stable at six and 12 months in all patients. No complications were observed in the follow-up period. The study did not look at endothelial cell loss at these higher energy levels. No patient developed corneal decompensation or cataract formation. These results are encouraging and in keeping with other accelerated treatment reports at 12 months, however, a longer follow-up period is required. 

Accelerated (9mW/cm2) corneal collagen cross-linking for keratoconus – a 1 year follow-up.
Elbaz U, Shen C, Lichtinger A, et al.
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Sharmina Khan

Moorfields Eye Hospital, London, UK

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