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Purpose <p>To compare the 24-month outcomes of accelerated contact lens-assisted corneal crosslinking (A-CACXL) in thin corneas (&lt; 400 microns) versus conventional accelerated CXL (A-CXL) in progressive keratoconus patients.</p> Methods <p>This study included progressive keratoconus patients who underwent A-CACXL (9&#xa0;mW/cm<sup>2</sup> for 10&#xa0;min) and A-CXL (9&#xa0;mW/cm<sup>2</sup> for 10&#xa0;min). A-CACXL was performed in cases with the thinnest corneal thickness of 400&#xa0;μm 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.</p> Results <p>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 (<i>p</i> &gt; 0.05). Preoperative thinnest corneal pachymetry measurements were significantly less in A-CACXL group (384.8 ± 25.2 vs. 450.4 ± 35.7; <i>p</i> &lt; 0.001). ΔBSCVA, RI, and ΔKmax 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) (<i>p</i> = 0.521). In the A-CACXL group, curvature-based index (ARC) improved significantly (<i>p</i> = 0.002), pachymetric indices (ARTmax, RPIavg) worsened significantly (<i>p</i> = 0.002, 0.026), while no change was observed in aberrometric parameters (<i>p</i> &gt; 0.05).</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年8月13日

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  • Fahri Onur Aydin,
  • Elif Bağatur Vurgun,
  • Gamze Özkan,
  • Semra Akkaya Turhan,
  • Ebru Toker

摘要

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/cm2 for 10 min) and A-CXL (9 mW/cm2 for 10 min). A-CACXL was performed in cases with the thinnest corneal thickness of 400 μm 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). ΔBSCVA, RI, and ΔKmax 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.