Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus: 1-year results

PurposeTo investigate the safety and efficacy of a new protocol for transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus treatment.MethodsThere were 26 patients (26 eyes) diagnosed with keratoconus enrolled in the study and treated with transepithelial accelerated corneal collagen cross-linking. The corneas were irradiated using UVA light for 5min and 20s with 45mW/cm(2) irradiance and pulsed illumination (1:1). The follow-up examinations were performed at 1day, 1month, 3months, 6months, and 1year postoperatively. At each follow-up, the patients received a complete ophthalmologic examination that included visual acuity, manifest refraction, corneal topography, endothelial cell density, and ORA.ResultsThe operations were uneventful, and there were no complications during follow-up. At 1year after the procedure, the uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of the treated eyes were significantly improved compared to the pretreatment values (P=0.012, 0.041, respectively). Additionally, 65.4% of eyes gained at least 1 line in CDVA, and 42.3% of eyes showed a reduction in at least 0.5D in astigmatism. The maximum keratometry (K-max), corneal thickness, corneal endothelial cell density and corneal biomechanics were stable at each visit.ConclusionTransepithelial accelerated corneal collagen cross-linking with higher oxygen availability was safe for keratoconus treatment and partially prevented disease progression. Therefore, further studies with large patient cohorts and longer follow-up periods are recommended.