scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives:to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background: Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods:Non-randomized controlled trialwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µmat 6 mm diameter utilizing either optimized (aberration free) or corneal WFG patterns (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results: Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions: both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs at 6 mm diameter with better aberrometric outcomes in corneal WFG group.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Corneal wavefront guided versus aberration free transepithelial photorefractive keratectomy in myopic patients with high pre-existing corneal higher order aberrations

2019 ◽  
Author(s):  
Amin Faisal Ellakwa ◽  
Marwa Ali Zaki ◽  
Rana Mohammed Ashour
Keyword(s):  
Visual Acuity ◽  
Higher Order ◽  
Single Step ◽  
Photorefractive Keratectomy ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Randomized Controlled ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Abstract Objectives to compare the efficacy, safety and predictability of corneal wavefront guided (WFG) and aberration free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in myopic patients with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Methods Non-randomized controlled trailwas conducted in El-HekmaEye-LASIK center, Menoufia governorate, Egypt during the period from January 2017 to December 2017. TransPRK was performed to eligible myopic patients with or without astigmatism with corneal HOAs ≥ 0.35 µ utilizing either aberration free or corneal WFG patterns provided by ORKCAM software (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Uncorrected distance visual acuity (UDVA), manifest and cycloplegic refractions, best spectacle corrected distance visual acuity (CDVA), thorough slit lamp examination and corneal topography were assessed and repeated six months postoperatively. Results Six months postoperatively, 97.6% and 100% of patients achieved MRSE within ± 1D with 76.2% and 66.67% of patients achieved UDVA of ≥20/20 in aberration free and corneal WFG groups respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (p=0.08, p=0.28 respectively) while significantly higher postoperatively in aberration free group (p<0.001, p=0.001 respectively). Coma and trefoil aberrations declined after corneal WFG technique, yet increased after aberration free one. Conclusions both aberration free and corneal WFG TransPRK were safe, effective and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

scholarly journals Comparison of the Clinical Performance of Refractive Rotationally Asymmetric Multifocal IOLs with Other Types of IOLs: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-13
Author(s):  
Zequan Xu ◽  
Wenzhe Li ◽  
Lianqun Wu ◽  
Shuang Xue ◽  
Xu Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Higher Order ◽  
Controlled Trials ◽  
Strehl Ratio ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Near Visual Acuity

Objective. To compare the clinical performance of refractive rotationally asymmetric multifocal intraocular lens (IOLs) with spherical monofocal, accommodating, and bifocal IOLs. Methods. A comprehensive literature search of PubMed, EMBASE, Cochrane Controlled Trials Register, and Web of Science up to February 2017 was performed to identify randomized controlled trials (RCT) and comparative cohort studies. Main outcomes were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), higher-order aberrations (HOAs), MTF, Strehl ratio, and residual sphere and cylinder. Results. Mplus provided significantly worse UDVA than spherical monofocal IOLs (WMD: 0.13, P=0.008), but significantly better UIVA than high-add bifocal IOLs (WMD: −0.19, P<0.00001), spherical monofocal IOLs (WMD: −0.12, P<0.0001), and accommodating IOLs (WMD: −0.21, P<0.00001). Mplus provided significantly worse UNVA than high-add bifocal IOLs (WMD: 0.07, P<0.00001), but significantly better UNVA than spherical monofocal IOLs (WMD: −0.19, P<0.00001). Mplus resulted in significantly higher HOAs than high-add bifocal IOLs (WMD: 0.38, P<0.00001) and spherical monofocal IOLs (WMD: 0.51, P=0.0004). Mplus provided a significantly lower MTF cut-off and Strehl ratio than other type of IOLs. Conclusion. The Mplus IOLs perform best regarding intermediate visual acuity whereas they lack in distance visual acuity compared to monofocal IOLs and near visual acuity compared to bifocal IOLs. These results may be due to structure of Mplus IOLs resulting in higher-order aberrations.

scholarly journals Toric phakic IOLs in keratoconus—evaluation of preoperative parameters on the outcome of phakic anterior chamber lens implantation in patients with keratoconus

2021 ◽  
Author(s):  
Isaak R. Fischinger ◽  
Jascha Wendelstein ◽  
Kristin Tetz ◽  
Matthias Bolz ◽  
Manfred R. Tetz
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Intraocular Lenses ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Lens Implantation ◽  
Efficacy Index ◽  
The Mean

Abstract Purpose To evaluate the influence of the type of the keratectasia and preoperative keratometry readings on the efficacy of implantation of iris-fixated phakic anterior chamber intraocular lenses (pIOL) in patients with keratoconus. Methods In this retrospective study, iris-fixated pIOLs (Artisan/Artiflex (Ophtec®), Verisyse/Veriflex (AMO®)) were implanted in 38 eyes of 22 patients with stable keratoconus. Thirty-six eyes underwent corneal crosslinking (CXL) prior to the lens implantation. The refractive outcome was evaluated 6 weeks postoperatively and the influence of preoperative refraction and topo- and tomographical factors were analyzed. Results The mean postoperative uncorrected distance visual acuity (UDVApost) was 0.25 ± 0.15 logMAR and was not statistically different from the mean preoperative corrected distance visual acuity (CDVApre), which was 0.24 ± 0.13 logMAR. Twenty-seven eyes (71%) reached UDVApost/CDVApre ≥ 1 (efficacy index), whereas patients with PMD-like ectasia (n = 14) showed significantly (p = 0.003) higher efficacy index (100%) than patients diagnosed with keratoconus (n = 24) (54%). Higher eccentricity of the maximum posterior elevation showed a significant beneficial influence on the efficacy index (p = 0.021). Furthermore, a higher Amsler-Krumeich stage and preoperative MAE were correlated with a worse UDVApost. The mean absolute spherical equivalent was significantly decreased from 5.71 ± 4.96 D to 1.25 ± 1.20 D (p < 0.001). No significant difference was found in endothelial cell count. Conclusion The results indicate that the implantation of phakic iris-fixated anterior chamber IOLs is a reasonable refractive option for patients with keratoconus. Keratoconus patients with a pellucidal marginal degeneration (PMD)-like appearance ectasia seem to benefit most from such procedures.

scholarly journals Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-Assisted and Flap-off Epi-LASIK

2020 ◽  
Author(s):  
JUNJIE PIAO ◽  
Woong-Joo Whang ◽  
Choun-Ki Joo
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Refractive Surgery ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Corneal Asphericity

Abstract Background This study clinically evaluated the visual outcomes after refractive surgery for myopia using femtosecond laser-assisted in situ keratomileusis (femto-LASIK) and epi-LASIK (flap-off). Methods In this prospective cohort study, 40 eyes of 27 patients were divided into two groups depending on the technique used for refractive surgery. Femto-LASIK flaps and epi-LASIK flaps (flap-off) were created using femtosecond laser and Epi-K TM epikeratome, respectively. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), corneal asphericity (Q-value), and corneal higher-order aberrations (HOAs) were assessed pre- and postoperatively. Results The improvement in LogMAR UDVA after refractive surgery was statistically significant for both groups ( P < 0.001 for all groups); it was significantly improved in the femto-LASIK group, 1 day and 1 week postoperatively ( P < 0.001, P = 0.019, respectively). With regard to the front and total corneal HOAs, there were significant differences in spherical aberrations (Z 4,0 ) between the femto-LASIK and flap-off epi-LASIK groups ( P = 0.016 and P = 0.017, respectively). With regard to the back corneal HOAs, there were significant differences in vertical coma (Z 3,-1 ) aberration, 0.027 ± 0.027 μm (femto-LASIK) and 0.001 ± 0.034 μm (flap-off epipolis LASIK); horizontal secondary astigmatism (Z 4,2 ) aberration, -0.008 ± 0.012 μm (femto-LASIK) and 0.007 ± 0.018 μm (flap-off epipolis LASIK); oblique tetrafoil (Z 4,-4 ) aberration, -0.008 ± 0.029 μm (femto-LASIK) and 0.015 ± 0.026 μm (flap-off epi-LASIK), respectively ( P = 0.018, P = 0.007, and P = 0.022, respectively). However, the back corneal HOA changes did not have a significant effect on the total corneal HOA changes. Conclusion Femto-LASIK yielded better early visual outcomes than did flap-off epi-LASIK, but there was no significant difference between the outcomes of the two procedures, 1 week postoperatively.

scholarly journals Corneal Asphericity and Higher-Order Aberrations after FS-LASIK and Trans-PRK for Myopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yuan Wu ◽  
Shuhan Wang ◽  
Guiqin Wang ◽  
Shaozhen Zhao ◽  
Ruihua Wei ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Higher Order ◽  
Corneal Surface ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Corneal Aberrations ◽  
Astigmatism Correction ◽  
Uncorrected Distance Visual Acuity ◽  
Corneal Asphericity

Objective. To compare the corneal asphericity and higher-order aberrations (HOAs) of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) with Smart Pulse Technology (SPT) assisted transepithelial photorefractive keratectomy (Trans-PRK) for myopia and myopic astigmatism correction. Methods. This prospective study analyzed 88 eyes of 44 patients treated with FS-LASIK and 64 eyes of 32 patients treated with Trans-PRK. All eyes had low to moderate myopia with or without astigmatism (spherical equivalent (SE) <−6.00 diopters). The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, asphericity (Q value) of the anterior corneal surface, index of surface variance (ISV), corneal higher-order aberrations (HOAs), vertical coma (Z3−1), horizontal coma (Z31), and spherical aberration (Z40) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and 1, 3, and 6 months postoperatively. Results. At 6 months, the UDVA and SE were −0.14 ± 0.06 and 0.33 ± 0.33D in FS-LASIK and −0.15 ± 0.06 and 0.35 ± 0.37D in Trans-PRK. There was no difference between the two groups in the postoperative UDVA and SE ( P > 0.05 ). After FS-LASIK and Trans-PRK, the Q values in the 6, 7, 8, and 9 mm zones and ISV of the anterior corneal surface significantly increased ( P < 0.001 ). At 1, 3, and 6 months after surgery, corneal HOA, Z3-1, Z31, and Z40 in both groups were significantly increased compared with those before surgery, with statistically significant differences ( P < 0.001 ). At 1, 3, and 6 months after surgery, the Z3−1 of the Trans-PRK group was significantly lower than that of the FS-LASIK group ( P < 0.001 ). ΔHOA and ΔZ40 were dramatically correlated with the ΔQ value for both FS-LASIK and Trans-PRK procedures. The ΔQ was significantly correlated with the preoperative SE, AD, and AD/CCT after both two procedures (all P < 0.001 ). Conclusions. Both FS-LASIK and Trans-PRK caused the anterior corneal surface to become flatter, and the morphology of the corneal surface was irregular. Corneal HOAs were significantly increased after the two procedures. Trans-PRK using SPT introduced less corneal vertical coma than FS-LASIK. Corneal asphericity changes contributed to the corneal aberrations changes following FS-LASIK and Trans-PRK.

scholarly journals Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK)

2021 ◽  
Vol 10 (9) ◽  
pp. 1939
Author(s):  
José-María Sánchez-González ◽  
Federico Alonso-Aliste ◽  
Davide Borroni ◽  
Jonatan Amián-Cordero ◽  
Concepción De-Hita-Cantalejo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Pain Score ◽  
Analogue Scale ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity

To evaluate the usage of plasma rich in growth factor (PRGF) in transepithelial photorefractive keratectomy (TPRK) in low and moderate myopia, patients who underwent myopic and astigmatism TPRK with PRGF were involved in this retrospective, observational study. Subjects underwent a surgical procedure between February 2019 and June 2019. A three-month follow-up was recorded. Pain score was assessed with a visual analogue scale (0–10) and re-epithelialization time recorded. A total of 48 eyes from 24 patients were recruited. Mean uncorrected distance visual acuity (UDVA) was 20/20.31 (0.00 ± 0.02 LogMAR). A total of 98% of eyes did not change corrected distance visual acuity (CDVA) lines. Two percent of eyes lost one line of CDVA. Preoperative spherical equivalent was −2.67 ± 1.37 D and after three months changed to −0.21 ± 0.34 D, and 2% of eyes changed 0.50 D or more between one and three months. Pain score was 3.29 ± 0.61 (3 to 6) score points at day one and 0.08 ± 0.27 score points at day seven. Finally, re-epithelialization time was 2.50 ± 1.20 days. PRGF addition to conventional refractive treatment such as TPRK seems to alleviate immediate postoperative pain and positively contribute to corneal re-epithelization time.

Laser in Situ Keratomileusis for High Hyperopia with Corneal Vertex Centration and Asymmetric Offset

2016 ◽  
Vol 27 (2) ◽  
pp. 141-152 ◽  
Author(s):  
Diego de Ortueta ◽  
Sam Arba-Mosquera
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Higher Order ◽  
Laser In Situ Keratomileusis ◽  
Higher Order Aberrations ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
High Hyperopia

Purpose To investigate refractive outcomes and induction of corneal higher order aberrations (HOA) in eyes that underwent laser-assisted in situ keratomileusis (LASIK) for high hyperopia correction using an aberration neutral profile with corneal vertex centration and asymmetric offset. Methods A total of 24 consecutive patients (38 eyes) who underwent LASIK by one surgeon using AMARIS 750S excimer laser and a Carriazo-Pendular microkeratome for flap creation were retrospectively analyzed. Eyes targeted for plano and with correction in the maximum hyperopic meridian strictly higher than +4D were included in the retrospective analysis. Patients were reviewed at 1, 3, and 6 months postoperatively. Postoperative monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, and corneal wavefront aberrations were compared with respective preoperative metrics. Results Mean preoperative spherical equivalent and refractive astigmatism was +4.07 ± 0.90 D and 1.37 ± 1.26 D, respectively, reducing to +0.28 ± 0.58D (p<0.0001) and 0.49 ± 0.47 D (p = 0.0001) at the last postoperative visit. Six months postoperatively, 78% of eyes achieved a UDVA of 20/25 or better. No eye lost more than 2 Snellen lines of CDVA at any follow-up. There was a statistically significant induction of vertical trefoil (+0.104 ± 0.299 µm, p<0.05), vertical coma (-0.181 ± 0.463 µm, p<0.01), horizontal coma (+0.198 ± 0.663 µm, p<0.05), spherical aberration (-0.324 ± 0.281 µm, p<0.0001), secondary vertical trefoil (+0.018 ± 0.044 µm, p<0.01), and secondary horizontal coma (+0.026 ± 0.083 µm, p<0.05) Conclusions Laser-assisted in situ keratomileusis for high hyperopia using corneal vertex centration with asymmetric offset results in significant improvement in refraction and visual acuity although affected by significant induction of some higher order aberrations.

scholarly journals Corneal Cross-Linking as Treatment in Pediatric Keratoconus: Comparison of Two Protocols

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shira Hed ◽  
Ran Matlov Kormas ◽  
Sagi Shashar ◽  
Boris E. Malyugin ◽  
Matthew Boyko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Time ◽  
Pediatric Population ◽  
Long Term Results ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Introduction. Keratoconus is a progressive corneal disease commonly treated by collagen cross-linking (CXL). Accelerated protocols have recently become common. This study sought to compare the outcomes of accelerated and standard CXL in terms of visual acuity, keratometry, and tomographic parameters in pediatric population. Methods. We retrospectively reviewed the files of pediatric patients who underwent standard and accelerated CXL for keratoconus in our hospital, between October 2014 and March 2018. Changes in uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), tomographic keratometry parameters (Kmax, Ksteep, Kflat, Kmean), and endothelial density count (EDC) were assessed before and at 6 and 12 months following treatment. The analysis included intergroup and intragroup comparisons. Results. This study included 53 eyes (44 patients). Fourteen eyes were treated with standard CXL (S-CXL, 3 mW/cm2, 30 min), while 39 underwent accelerated CXL (A-CXL, 9 mW/cm2, 10 min). Intergroup comparison found insignificant differences between groups, with the exception of better results for UCDVA in the S-CXL group after 12 months ( P  = 0.03). In this study, there was no significant difference between the two protocols postoperatively in BCDVA, Kmax, Kmean, pachymetry, or corneal astigmatism. Conclusion. A-CXL is as safe and effective as S-CXL for stabilizing progressive keratoconus in pediatric population. Larger-sample-size studies with a longer follow-up time are required. Considering the long-term results of 9 mW A-CXL and its safety and efficacy profile, it should be preferred to S-CXL for reducing treatment time and improving patients’ comfort.

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