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Shajari, M; Kolb, CM; Agha, B; Steinwender, G; Müller, M; Herrmann, E; Schmack, I; Mayer, WJ; Kohnen, T.
Comparison of standard and accelerated corneal cross-linking for the treatment of keratoconus: a meta-analysis.
Acta Ophthalmol. 2019; 97(1):e22-e35-e22-e35
Doi: 10.1111/aos.13814
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- Co-authors Med Uni Graz
- Steinwender Gernot
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- Abstract:
- To compare results between standard and accelerated corneal collagen cross-linking (CXL) for the treatment of progressive keratoconus. We performed literature searches in PubMed, Cochrane Library, Web of Science, ISRCTN registry, ClinicalTrials.gov, and EMBASE for studies comparing conventional Dresden (C-CXL) and accelerated CXL (A-CXL). Outcomes were clinical results and changes in corneal properties. Weighted mean differences were used to evaluate the effects. Here, 22 studies with 1158 eyes (C-CXL: 577 eyes; A-CXL: 581 eyes) were included. At the last follow-up, C-CXL was superior regarding minimum keratometry (p < 0.00001) and demarcation line depth (p < 0.00001), whereas A-CXL should be favoured when considering minimum corneal thickness (p = 0.0005). No differences in uncorrected and corrected distance visual acuity (p = 0.09 and 0.98), spherical equivalent (p = 0.11), spherical and cylindrical error (p = 0.29 and 0.32), maximal and average keratometry (p = 0.05 and 0.65), central corneal thickness (p = 0.15), corneal biomechanical properties (p ≥ 0.21 respectively), time of reepithelialization (p = 0.76), subbasal nerve density (p = 0.69), endothelial cell density (p = 0.30) and morphology (p ≥ 0.40 respectively) were found among both groups. Consideration of less corneal thinning favours A-CXL, whereas the deeper demarcation line and greater changes in minimum keratometric values in C-CXL may indicate a higher treatment efficacy. Altogether, C-CXL, as well as A-CXL, provides successful results in the strengthening of corneal tissue. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
- Find related publications in this database (Keywords)
- accelerated cross-linking
- corneal collagen cross-linking
- different cross-linking protocols
- progressive keratoconus
- standard Dresden cross-linking