Table 4.
Review of studies comparing conventional and accelerated crosslinking.
| Study | Study design | Conventional crosslinking | Accelerated crosslinking |
Follow up
(months) |
Findings | ||
|---|---|---|---|---|---|---|---|
| N | Protocol/ platform | N | Protocol/ platform | ||||
| Kanellopoulos, 2012 | Prospective randomized comparative case series | 21 | 3mW/cm2 for 30 mins | 21 | 7mW/cm2 for 15 mins | 46 | Comparable changes in visual acuity, refraction, reduction in steepest K, no progression in both groups |
| Cinar et al. 2014 | Prospective comparative case series | 13 | 3mW/cm2 for 30 mins | 13 | 9mW/cm2 for 10 mins | 6 | Comparable visual and refractive results, decrease in Km and Kmax in both groups |
| Brittingham et al. 2014 | Retrospective case series | 81 | 3mW/cm2 for 30 mins UV-X 1000 |
50 | 9mW/cm2 for 10 mins UV-X 2000 |
12 | Increased steepening of anterior cornea in accelerated (+0.72D) compared to conventional group (-0.76D) |
| Ng et al. 2015 | Retrospective comparative case series | 14 | 3mW/cm2 for 30 mins UV-X 1000 |
12 | 9mW/cm2 for 10 mins UV-X 2000 |
12 | Greater reduction in Kmax and Kmean in conventional group compared to accelerated group |
| Hashemi et al. 2015 | Prospective randomized comparative case series | 31 | 3mW/cm2 for 30 mins UV-X |
31 | 18mW/cm2 for 5 mins UV-X |
6 | Comparable visual acuity, refractive, keratometric and biomechanical outcomes |
| Chow et al. 2015 | Prospective comparative case series | 19 | 3mW/cm2 for 30 mins UV-X |
19 | 18mW/cm2 for 5 mins CCL-VARIO |
12 | Comparable visual acuity and refractive outcomes. More topographic flattening in the conventional group compared to accelerated group |
| Hashemian et al. 2014 | Prospective randomized controlled trial | 153 | 3mW/cm2 for 30 mins CCL-VARIO |
77 | 30mW/cm2 for 3 mins CCL-VARIO |
15 | Comparable changes in visual acuity, refraction, endothelial cell density, Kmax, anterior stromal keratocyte density and subbasal nerve density |
| Sherif, 2014 | Prospective randomized comparative study | 11 | 3mW/cm2 for 30 mins UV-X |
14 | 30mW/cm2 for 4 mins and 20s Avedro KXL |
12 | Comparable reduction in Kmax, changes in corneal hysteresis, corneal resistance factor and central corneal thickness |
| Tomita et al. 2014 | Prospective comparative study | 18 | 3mW/cm2 for 30 mins CCL VARIO |
30 | 30mW/cm2 for 3 mins Avedro KXL |
12 | Comparable changes in visual acuity, refractive, keratometric readings, biomechanical responses between the 2 groups |
| Shetty et al. 2015 | Prospective randomized interventional study | 36 | 3mW/cm2 for 30 mins Avedro KXL |
36 | 9mW/cm2 for 10 mins | 12 | Conventional group and accelerated groups with irradiance of 9mW/cm2 and 18mW/cm2 showed better visual, refractive and tomographic improvements. Minimal stabilization of disease in 30mW/cm2 group |
| 33 | 18mW/cm2 for 5 mins | ||||||
| 33 | 30mW/cm2 for 3 mins Avedro KXL for all groups |
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