Pulsed light epithelium-off accelerated corneal collagen crosslinking with 30mW/cm2 irradiance and 7.2 J/cm2 radiant exposure: 2-year results.

Objective: To evaluate the 2-year outcomes of pulsed light epithelium-off accelerated corneal collagen crosslinking (aCXL) using 30 mW/cm2 for 8 min (7.2 J/cm2) for the treatment of progressive keratoconus.

Methods: A total of 23 eyes of 18 patients with progressive keratoconus, that were treated with epithelium-off pulsed light aCXL (30 mW/cm2, 8 min) were included in this retrospective study. Tomographic measurements and corrected distance visual acuity (CDVA) were analyzed at the baseline visit (before the aCXL treatment), and at 3-, 12- and 24-months visit.

Results: The two-year results demonstrated a stable anterior flat keratometry (K1), steep keratometry (K2) and mean keratometry (Kmean) of the anterior and posterior cornea with no significant changes at 3, 12 and 24 months postoperatively, compared to the baseline visit (p > 0.05). Maximal anterior keratometry (Kmax) stabilized from 60.18 ± 6.32 D at baseline to 60.04 ± 7.36 D at 24 months post-aCXL (p = 0.88). The keratoconus indices and astigmatism of the front and back surface of the cornea also showed stable results. The CDVA improved from 0.69 ± 0.29 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.35 ± 0.21 logMAR at 24 months postoperatively (p = 0.16).

Conclusions: Pulsed light epithelium-off accelerated CXL using 30 mW/cm2 for 8 min (7.2 J/cm2) appears to be an effective treatment modality halting progression of keratoconus even after two years.