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Abstract
Purpose
To evaluate the safety and efficacy of higher fluence cornea collagen cross linking (CXL).
Methods
Twenty-one patients with bilateral keratoconus had randomized CXL in one eye (group A) with 7 mw/cm2 for 15 minutes; the other eye (group B) had the standard 3 mw/cm2 for 30 minutes; 50 um PTK with the Eye-Q 400 Hz Excimer laser (Wavelight, Erlagen, Germany) was used for epithelial removal. The patients were evaluated postoperatively at the following intervals: day 1, day 4, month 1, month 3, and then every 6 months.
Results
For groups A and B respectively, in mean values: uncorrected distance visual acuity (UDVA) improved from 20/60 to 20/38, and 20/62 to 20/40; best corrected visual acuity (BCVA) from 20/30 to 20/25 in both groups; mean sphere was reduced by 2.5 and 2.1 diopters; mean cylinder was reduced by 2.9 and 2.5 diopters on average; Steepest K was reduced from 49.5 to 46.1, and from 48.7 to 45.8 diopters. There was no ectasia progression in any of the cases during the follow-up time studied. There was no change in the endothelial cell count. All patients returned to full activities postoperatively within a month. Four cases from group A and five cases from group B had delayed epithelial healing (completed by postoperative day 9). No other adverse effects were noted in any of the cases studied. Mean follow-up was 46 months (18–56). Corneal optical coherence tomography (OCT) revealed diffused light scattered in anterior two-thirds of the cornea stroma, which was more intense and much broader in diameter in group A than in group B.
Conclusion
This novel technique offers similar clinical results in ectasia stabilization without any adverse effects noted.
Disclosure
The authors report no conflicts of interest in this work.