July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Compared effectiveness of Dresden-protocol versus pulsed-accelerated crosslinking for halting keratectasia in progressive keratoconus
Author Affiliations & Notes
  • Liam O'Sullivan
    Ophthalmology, Queen's University, Kingston, Ontario, Canada
  • Davin Johnson
    Ophthalmology, Queen's University, Kingston, Ontario, Canada
  • Ankur Ralhan
    Ophthalmology, Queen's University, Kingston, Ontario, Canada
  • Footnotes
    Commercial Relationships   Liam O'Sullivan, None; Davin Johnson, None; Ankur Ralhan, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6322. doi:
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      Liam O'Sullivan, Davin Johnson, Ankur Ralhan; Compared effectiveness of Dresden-protocol versus pulsed-accelerated crosslinking for halting keratectasia in progressive keratoconus. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6322.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Pulsed-accelerated crosslinking is a newer corneal crosslinking protocol that can improve the efficiency of practice and patient comfort by reducing the duration of the crosslinking procedure. Owing to its relative novelty, there is a paucity of evidence for its comparative effectiveness in the literature. We compare the effectiveness of pulsed-accelerated versus Dresden-protocol corneal crosslinking procedures in halting progression of keratectasia in patients with keratoconus, using topometric and tomographic measures of the cornea obtained with Schliempflug tomography.

Methods : In this open-label, non-randomized, retrospective observational study, thirty-six eyes were treated for clinically-proven progressive keratoconus with either a conventional crosslinking procedure according to the Dresden protocol (n=20) or a pulsed-accelerated crosslinking procedure (n=16). Disease progression was measured as the difference in topometric (Anterior Float, Posterior Float, Posterior Rmin, Anterior Kmax, Anterior Kmin, Anterior Astigmatism, Posterior Kmax, Posterior Kmin, Posterior Astigmatism, ISV, IVA, KI, CKI, IHA, IHD) and tomographic measures (Pachymin, Pachycenter) of the cornea between the time of procedure and after procedure (mean follow-up = 6.26 ± 0.53 months). This difference was compared between study arms to evaluate for non-inferiority of procedure using a student’s t-test.

Results : No significant difference was determined between study arms in the change in major topometric values (Anterior Kmax, p=0.47; Anterior Astigmatism, p=0.23; Posterior Kmax, p=0.45; Posterior Astigmatism, p=0.32; ISV, p=0.39; IVA, p=0.49; KI, p=0.11; CKI, p=0.65; IHA, p=0.52; IHD p=0.45) and tomographic measures (Pachymin, p=0.11; Pachycenter, p=0.11) over the follow-up period.

Conclusions : Both pulsed-accelerated and Dresden-protocol procedures were effective in halting the progression of keratoconus, with each group experiencing no significant change in any of the study-measurement values after the follow-up period. The change in each measurement value within study arms over time were then compared between study arms and no significant difference was shown between those patients receiving Dresden-protocol or pulsed-accelerated crosslinking. We observed equivalency in the effectiveness of each procedure for halting keratectasia in progressive keratoconus.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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