title: Accelerated (18 mW/cm²) Corneal Collagen Cross-Linking for Progressive Keratoconus.
abstract: OBJECTIVE
  The aim of this study was to determine the efficacy of accelerated riboflavin-ultraviolet A-induced corneal collagen cross-linking (CXL) (irradiance of 18 mW/cm² for 5 minutes).
  
  
  METHODS
  In this study, we retrospectively reviewed the charts and anterior segment data of patients after accelerated CXL. Visual, topographic, pachymetry, and densitometry data were extracted and analyzed before surgery and at follow-up (minimum 12 months) after treatment.
  
  
  RESULTS
  A total of 28 eyes of 20 patients (mean age, 28.1 ± 8.1 years) were included in this study. The mean follow-up time was 21.7 ± 7.2 months (range, 12-34 months). No statistically significant changes were found in the mean corrected distance visual acuity, corneal astigmatism, Kmean, Kflat, Ksteep, corneal pachymetry (at the apex and at the thinnest point), and corneal densitometry at follow-up. A significant reduction of Kmax, index of surface variance, index of vertical asymmetry, and Km of the posterior corneal surface (Km(B)) was observed (Kmax: P = 0.018; index of surface variance: P = 0.016; index of vertical asymmetry: P = 0.038; Km(B): P = 0.008). No complications were reported during the postoperative follow-up period in this study.
  
  
  CONCLUSIONS
  Based on a mean follow-up time of 21.7 months, accelerated CXL (18 mW/cm; 5 minutes) is effective in stopping the progression of keratoconus without raising any safety concerns. Improvement in Kmax and stabilization of corrected distance visual acuity were noted after treatment. However, prospective studies with longer follow-up using different accelerated CXL settings are needed to validate these findings.
authors.affiliation: *Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany; and †Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
authors.forename: Maged
authors.initials: M
authors.lastname: Alnawaiseh
authors.forename: André
authors.initials: A
authors.lastname: Rosentreter
authors.forename: Michael R R
authors.initials: MR
authors.lastname: Böhm
authors.forename: Maria
authors.initials: M
authors.lastname: Eveslage
authors.forename: Nicole
authors.initials: N
authors.lastname: Eter
authors.forename: Lars
authors.initials: L
authors.lastname: Zumhagen
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin