Two-year outcomes of accelerated contact lens-assisted corneal crosslinking versus accelerated corneal crosslinking: a comparative study


Aydin F. O., Vurgun E. B., Ozkan G., Turhan S., Toker E.

INTERNATIONAL OPHTHALMOLOGY, cilt.45, sa.1, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 45 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s10792-025-03707-y
  • Dergi Adı: INTERNATIONAL OPHTHALMOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Purpose: To compare the 24-month outcomes of accelerated contact lens-assisted corneal crosslinking (A-CACXL) in thin corneas (< 400 microns) versus conventional accelerated CXL (A-CXL) in progressive keratoconus patients. Methods: This study included progressive keratoconus patients who underwent A-CACXL (9 mW/cm(2) for 10 min) and A-CXL (9 mW/cm(2) for 10 min). A-CACXL was performed in cases with the thinnest corneal thickness of 400 mu m or less. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), keratometric, tomographic, aberrometric values, and Regularization Index (RI) were compared at a 2-year follow-up. Results: The study enrolled 41 eyes; 20 eyes underwent A-CACXL and 21 eyes underwent A-CXL. Preoperative BSCVA, Kmax, K1, and K2 values were similar in both groups (p > 0.05). Preoperative thinnest corneal pachymetry measurements were significantly less in A-CACXL group (384.8 +/- 25.2 vs. 450.4 +/- 35.7; p < 0.001). Delta BSCVA, RI, and Delta Kmax were similar in A-CACXL and A-CXL groups (- 0.14 +/- 0.27 vs. - 0.17 +/- 0.18; 5.9 D +/- 4.9 D vs. 4.6 D +/- 2.5 D; - 2.0 +/- 3.5 D vs. - 2.0 +/- 3.1 D; respectively). A-CACXL showed 95% of eyes halting progression, with 60% showing regression, similar to A-CXL (57.1% regression, 100% halting progression) (p = 0.521). In the A-CACXL group, curvature-based index (ARC) improved significantly (p = 0.002), pachymetric indices (ARTmax, RPIavg) worsened significantly (p = 0.002, 0.026), while no change was observed in aberrometric parameters (p > 0.05). Conclusion: In eyes with thin corneas and progressive keratoconic condition, the safety and effectiveness of A-CACXL seemed comparable to that of A-CXL at the 2-year follow-up. Both techniques yielded similar visual, keratometric, tomographic, and aberrometric results.