Customized Corneal Crosslinking- One Year Results

• Published in: American journal of ophthalmology
• Main Authors: Seiler, Theo G., MD, Fischinger, Isaak, MD, Koller, Tobias, MD, Zapp, Daniel, MD, Frueh, Beatrice E., MD, Seiler, Theo, MD, PhD
• Format: Journal Article
• Language: English
• Published: 2015
• Subjects: Ophthalmology
• ISSN: 0002-9394
• DOI: 10.1016/j.ajo.2016.02.029

Abstract Purpose To compare the efficacy of customized corneal crosslinking (CXL) with standard CXL. Design Prospective, non-randomized comparative clinical study Setting Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland Methods In a prospective study, 40 eyes of 40 patients with documented progressive primary keratoconus were treated with customized CXL (n=20) or standard CXL (n=20) and followed for 1 year. Customized irradiation patterns had an energy fluence of 9mW/cm2 and total energy levels ranging from 5.4J/cm2 up to 10J/cm2 and were centered on the maximum of the posterior float. The control group received homogenous irradiation with a fluence of 9mW/cm2 and a total energy of 5.4J/cm2 . Scheimpflug tomographies, endothelium cell count, best spectacle-corrected visual acuity (BSCVA) and anterior segment optical coherence tomography (OCT) were compared preoperatively and 1 year post-op. Results Pachymetry and ΔKmax showed significant changes 1 year postoperatively within each group. Epithelial healing time, ΔKmax and regularization index (RI) were significantly better in the customized CXL group. Two out of 19 eyes (11%) in the standard group but 7 out of 19 eyes (37%) showed in the customized CXL-group a flattening of 2 or more diopters (p=0.03). The RI was 5.2D±2.7D in the customized group resp. 4.1D±3.1D in the control group (p=0.03). Statistically significant correlations between RI and preoperative Kmax , preoperative pachymetry and preoperative posterior float were found only in the customized group. Conclusions Customized CXL seems to be as safe as standard CXL with stronger flattening in Kmax and RI, and a faster epithelial healing period.