Pilot study of transepithelial, very high fluence accelerated corneal collagen cross-linking in primary keratoconus

Objective Evaluate the safety and effectiveness of transepithelial, very high fluence accelerated corneal collagen cross-linking (A-CXL) in primary keratoconus. Methods Self-control study. Thirteen primary keratoconus eyes of 13 patients were treated with transepthelial, very high fluence A-CXL with a UVA intensity of 45 mW/cm2, an irradiation time of 2 min 40 s, and a total energy of 7.2 J/cm2. Routine ophthalmologic examination, UCVA, BCVA, refractive error, corneal keratometry, anterior and posterior elevation (AE and PE), index of vertical asymmetry (IVA), minimum corneal thickness (CT) , compensated intraocular pressure (IOPcc), endothelial cell density (ECD) were evaluated pre-operatively and 7-day, 1-month, 3-month, 6-month, 12-month post-operatively. Results The UCVA (F=6.111 ,P 0.05), ECD (F=1.812,P>0.05) and IOPcc (F=0.332,P>0.05) were without significant change. Conclusion Transepithelial, very high fluence A-CXL is safe and effective in treating primary keratoconus. Key words: Corneal collagen cross-linking; Accelerated cross-linking; High energy; Keratoconus; Transepithial methods; Therapy outcome