Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.
ElShiwy, H., Salah-Eldin, Y., Sherif, A., Mohamed Mohamed, E., Elbakry, A. (2023). Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.. EKB Journal Management System, 3(3), 154-168. doi: 10.21608/ejomos.2022.176815.1078
Hoda Taha ElShiwy; Yehia Mahmoud Salah-Eldin; Ahmed Mohamed Sherif; Elham Moustafa Mohamed Mohamed; Amr Ahmad Elbakry. "Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.". EKB Journal Management System, 3, 3, 2023, 154-168. doi: 10.21608/ejomos.2022.176815.1078
ElShiwy, H., Salah-Eldin, Y., Sherif, A., Mohamed Mohamed, E., Elbakry, A. (2023). 'Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.', EKB Journal Management System, 3(3), pp. 154-168. doi: 10.21608/ejomos.2022.176815.1078
ElShiwy, H., Salah-Eldin, Y., Sherif, A., Mohamed Mohamed, E., Elbakry, A. Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.. EKB Journal Management System, 2023; 3(3): 154-168. doi: 10.21608/ejomos.2022.176815.1078

Safety and Efficacy of Conventional Versus Accelerated Corneal Collagen Cross-Linking in Keratoconus and Corneal Ectatic Diseases.

Egyptian Journal of Ophthalmology
Volume 3, Issue 3, September 2023, Pages 154-168    PDF (4.29 M)
Document Type: Original Articles
DOI: 10.21608/ejomos.2022.176815.1078
Authors
Hoda Taha ElShiwy* 1; Yehia Mahmoud Salah-Eldin2; Ahmed Mohamed Sherif3; Elham Moustafa Mohamed Mohamed4; Amr Ahmad Elbakry2
1Ophthalmology Department, Kasr Alainy school of medicine, Cairo University, Cairo, Egypt
2Ophthalmology Department, Kasr Alainy school of Medicine, Cairo University, Cairo, Egypt
3Ophthalmology Department, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
4Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Abstract
Purpose: This study compares the efficacy and safety of conventional versus accelerated corneal collagen cross linking in treatment of progressive keratoconus.
Methods: This non-randomized interventional study was conducted on 79 eyes with keratoconus or corneal ectatic diseases. Patients’ eyes were divided into two groups, group A (n=35 eyes) underwent conventional crosslinking (cCXL) and group B (n=44 eyes) underwent the accelerated (KXL) technique.
Results: No eyes lost any lines of visual acuity and more than 80% gained 1-4 lines in both UCVA and BCVA in both groups. Comparing both groups after 6 months, a more significant decrease in ECD was seen in the accelerated group at 6months (p=0.011), the mean cylindrical error showed a more significant improvement in the accelerated group (p=0.044), less reduction of pachymetry at thinnest location in KXL (P=0.008), but the mean depth of the demarcation line was significantly better and more homogenous in the conventional group (363.57±46.92µm) than the accelerated group (319.56±36.50µm) (P<0.001). Both groups showed insignificant change in the coefficient of variation for specular microscopy (P=0.574 and 0.528).
Conclusion: both types offer a significant improvement in UCVA and BCVA values, but cCXL offers a deeper demarcation line and less endothelial loss. KXL offers less reduction in pachymetry and better cylinder correction.
Keywords
Conventional cross-linking; accelerated cross-linking; depth of corneal demarcation; Endothelial cell count
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