SEARCHCOHORTophthalmology, cornea

cohort·ophthalmology, cornea, refractive surgery, observational study·PMC10764350

Comparison of standard versus accelerated corneal collagen cross-linking for keratoconus: 5-year outcomes from the Save Sight Keratoconus Registry

Eye · 8 authors, 6 centres

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TL;DR

This observational registry study compared standard and accelerated corneal cross-linking protocols for keratoconus over 5 years.

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Both protocols effectively stabilized the condition. For example, the adjusted mean gain in visual acuity was 10.2 letters for standard versus 4.9 letters for accelerated CXL. Adverse events were infrequent in both groups, with haze being the most common and mostly resolving by the 5-year follow-up.

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cohort

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ophthalmology

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ORIGINAL PAPER

PMC10764350

Comparison of standard versus accelerated corneal collagen cross-linking for keratoconus: 5-year outcomes from the Save Sight Keratoconus Registry

Eye

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ABSTRACT

Objective To compare long-term effectiveness of Standard (UV intensity: 3 mW/cm 2 , duration: 30 min) vs Accelerated (UV intensity: 9 mW/cm 2 , duration: 10 min) corneal cross-linking (CXL) for stabilising keratoconus. Methods Data for this observational study were captured through a web-based registry system from the routine clinical practice (15 sites across Australia, New Zealand and Italy). The outcomes were compared using mixed-effects regression models. A total of 100 eyes (75 patients) who had standard CXL and 76 eyes (66 patients) who had accelerated CXL, with a follow-up visit at five-year post-CXL were included. Results Both CXL protocols were effective and safe in stabilising keratoconus and improving outcomes. The adjusted mean changes (95% CI) in outcomes were better in standard CXL than in accelerated CXL [visual acuity gain, 10.2 (7.9–12.5) vs 4.9 (1.6–8.2) logMAR letters; pinhole visual acuity 5.7 (3.5–7.8) vs 0.2 (−2.2 to 2.5) logMAR letters; Kmax −1.8 (−4.3 to 0.6) vs 1.2 (−1.5 to 3.9)D; K2 −0.9 (–2.2 to 0.3) vs 0.1 (−1.3 to 1.6)D; MCT –3.0 (−13.7 to 7.7) vs −11.8 (−23.9 to 0.4) µm ( p values for visual acuity, pinhole visual acuity, Kmax: <0.05; for K2 and MCT: >0.05)]. The frequency of adverse events at the 5-year follow-up visit was low in both groups [standard, 5 (5%; haze 3; scarring 1, epithelial defect 1) and accelerated 3 (3.9%; haze 2, scarring 1)]. Conclusions Both standard and accelerated CXL were safe and effective procedures for stabilising keratoconus in the long term. The standard CXL resulted in greater improvements in visual acuity and keratometry.

CITATION EXPORT

Himal Kandel, Marco Abbondanza, Aanchal Gupta et al.. Comparison of standard versus accelerated corneal collagen cross-linking for keratoconus: 5-year outcomes from the Save Sight Keratoconus Registry. Eye. (2023). https://doi.org/10.1038/s41433-023-02641-6

AUTHORS

8 · 6 CENTRES

Himal Kandel, Marco Abbondanza, Aanchal Gupta, Richard Mills, Adam S. Watson, Constantinos Petsoglou, Yves Kerdraon, Stephanie L. Watson

1https://ror.org/0384j8v12grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Medicine and Health, Save Sight Institute, Sydney, NSW Australia
2Abbondanza Eye Centres, Rome and Milan, Rome, Italy
3Adelaide Eye & Laser Centre, Adelaide, SA Australia
4grid.1010.00000 0004 1936 7304South Australian Institute of Ophthalmology, Adelaide, SA Australia
5grid.1014.40000 0004 0367 2697Flinders Medical Centre, Flinders University, Adelaide, SA Australia
6Eye Institute, Auckland, New Zealand