title: High-irradiance accelerated collagen crosslinking for the treatment of keratoconus: six-month results.
abstract: OBJECTIVE
  To evaluate the effectiveness of accelerated corneal collagen crosslinking (CXL) with riboflavin for keratoconus by the change in dioptric power and corneal topography.
  
  
  METHODS
  Private practice, Tokyo, Japan.
  
  
  METHODS
  Case series.
  
  
  METHODS
  The accelerated CXL treatments (KXL system) were performed using a 10-minute riboflavin 0.1% (Vibex Rapid) soak and a 3-minute ultraviolet-A (UVA) irradiance at a level of 30 mW/cm(2). This corresponds to a total radiant exposure of 5.4 J/cm(2). Preoperative and 1, 3, and 6 months postoperative examinations were performed.
  
  
  RESULTS
  The study enrolled 39 eyes of 22 patients. The mean uncorrected distance visual acuity showed a statistically significant improvement, from 1.11 ± 0.42 logMAR preoperatively to 0.89 ± 0.53 logMAR 6 months postoperatively (P<.01). The mean maximum keratometry readings also changed significantly, from 49.95 ± 6.11 diopters (D) preoperatively to 49.19 ± 5.82 D at 6 months (P<.01). There were no statistically significant changes in the endothelial cell density between preoperatively and postoperatively.
  
  
  CONCLUSIONS
  The changes after accelerated CXL were similar to those after conventional CXL. Thus, accelerated CXL has the potential to efficiently treat and halt the progression of keratoconus and may be an effective, efficient therapeutic option for treating corneal ectatic disease.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Shinagawa LASIK Center (Mita, Tomita), Chiyoda-ku, and Minoru Tomita Eye Clinic Ginza (Mita, Tomita), Chuo-ku, Tokyo, Japan; the Storm Eye Institute, Medical University of South Carolina, Magill Vision Center, Charleston, and the Department of Bioengineering and Science (Waring), Clemson University, Clemson, South Carolina, USA; the Department of Ophthalmology (Tomita), Wenzhou Medical College, Wenzhou, China. Electronic address: harvardmedical1972@gmail.com.
authors.forename: Mariko
authors.initials: M
authors.lastname: Mita
authors.affiliation: From Shinagawa LASIK Center (Mita, Tomita), Chiyoda-ku, and Minoru Tomita Eye Clinic Ginza (Mita, Tomita), Chuo-ku, Tokyo, Japan; the Storm Eye Institute, Medical University of South Carolina, Magill Vision Center, Charleston, and the Department of Bioengineering and Science (Waring), Clemson University, Clemson, South Carolina, USA; the Department of Ophthalmology (Tomita), Wenzhou Medical College, Wenzhou, China.
authors.forename: George O
authors.initials: GO
authors.lastname: Waring
authors.affiliation: From Shinagawa LASIK Center (Mita, Tomita), Chiyoda-ku, and Minoru Tomita Eye Clinic Ginza (Mita, Tomita), Chuo-ku, Tokyo, Japan; the Storm Eye Institute, Medical University of South Carolina, Magill Vision Center, Charleston, and the Department of Bioengineering and Science (Waring), Clemson University, Clemson, South Carolina, USA; the Department of Ophthalmology (Tomita), Wenzhou Medical College, Wenzhou, China.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomita
mesh_terms: D000293:Adolescent; D000328:Adult; D002452:Cell Count; D003094:Collagen / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin