Comparison Between Pulsed and Continuous Accelerated Corneal Cross-Linking Protocols.

IF 1.8 Q3 OPHTHALMOLOGY Clinical ophthalmology Pub Date : 2023-01-01 DOI:10.2147/OPTH.S409178
Mohamed Omar Yousif, Rania Serag Elkitkat, Noha Abdelsadek Alaarag, Mouamen Moustafa Seleet, Ashraf Hassan Soliman
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Abstract

Purpose: To compare between two accelerated corneal cross-linking (A-CXL) protocols in the management of keratoconus (KC) as regard to the extent of corneal treatment.

Methods: This retrospective, comparative study included patients having mild to moderate, progressive KC. The study population was divided into two groups; group 1 enrolled 103 eyes of 62 patients who received pulsed light A-CXL (pl-CXL) at a power of 30 mW/cm2 with an irradiation time of 4 minutes, while group 2 comprised 87 eyes of 51 patients who received continuous light A-CXL (cl-CXL) at a power of 12 mW/cm2 with an irradiation time of 10 minutes. Recordings of the central and peripheral demarcation line depths (DD), and the maximum (DDmax) and minimum (DDmin) DD, using anterior segment optical coherence tomography, were compared between the two studied groups one month after the treatment protocol. Treatment stability was also evaluated pre and postoperatively (one year following surgery) by comparing the refractive and keratometric outcomes in both groups.

Results: The differences between the preoperative corneal thickness (minimum and central) and the epithelial thickness measurements between both groups were not statistically significant. Although group 1 had slightly larger central DD (223.4 ± 62.3 um), DDmax (240.4 ± 61.8 um), and DDmin (201 ± 54 um) than those of group 2 (221.8 ± 37 um, 229.1 ± 38.4 um, and 212 ± 37.2 um, respectively), the differences between both groups' measurements were not statistically significant. Also, the two groups showed statistically insignificant differences regarding the subjective refraction and the average and maximum keratometry pre and postoperatively, denoting visual, refractive, and keratometric stability in both groups.

Conclusion: Longer duration cl-CXL seems to be as effective as pl-CXL regarding both postoperative stability and the extent of corneal tissue penetration by the ultraviolet treatment.

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脉冲和连续加速角膜交联方案的比较。
目的:比较两种加速角膜交联(A-CXL)治疗圆锥角膜(KC)的角膜治疗程度。方法:本研究为回顾性比较研究,纳入轻至中度进展性KC患者,研究人群分为两组;第1组纳入62例患者103眼,接受功率为30 mW/cm2的脉冲光a - cxl (pl-CXL),照射时间为4分钟;第2组纳入51例患者87眼,接受功率为12 mW/cm2的连续光a - cxl (cl-CXL),照射时间为10分钟。在治疗方案后1个月,比较两组患者的中央和外周分界线深度(DD)以及最大(DDmax)和最小(DDmin)的记录。通过比较两组的屈光和角膜测量结果,还评估了术前和术后(手术后一年)的治疗稳定性。结果:两组术前角膜厚度(最小和中心)和上皮厚度测量值差异无统计学意义。虽然1组的中心DD(223.4±62.3 um)、DDmax(240.4±61.8 um)和DDmin(201±54 um)略大于2组(分别为221.8±37 um、229.1±38.4 um和212±37.2 um),但两组间的测量差异无统计学意义。此外,两组在主观屈光、平均和最大角膜度数方面的术前和术后差异无统计学意义,表明两组的视力、屈光和角膜度数稳定性。结论:在紫外线治疗的术后稳定性和角膜组织穿透程度方面,持续时间较长的cl-CXL似乎与pl-CXL一样有效。
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来源期刊
Clinical ophthalmology
Clinical ophthalmology OPHTHALMOLOGY-
CiteScore
3.50
自引率
9.10%
发文量
499
审稿时长
16 weeks
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