Table 3. Design and outcomes of studies with a standardized protocol and at least 1-year follow-up using ACXL at 9 mW/cm2.
First author, year | Study design | Eye/patient | Mean age (range, y) | Follow-up (mo) | Duration (min)/intensity (mW/cm2) | Riboflavin/soaking time (min) | Apparatus | ΔCDVA (logMAR) | ΔMRSE (D) | ΔKs (D) | ΔKmax (D) | ΔCCT (µm) | DLD (µm) | ΔECD (cell/mm2) |
Elbaz, 2014[13] | Retrospective | 16/14 | 24.9 (17.1-38.3) | 12 | 10/9 | 0.1% RF in 20% dex/30 | UV-X 2000 | -0.01 | 0.25 | 0.02 | -0.06 | N/A | N/A | N/A |
Shetty, 2014[14] (pediatric) | Prospective | 30/18 | 12.7 (11-14) | 24 | 10/9 | 0.1% RF in 20% dex/30 | Avedro KXL | -0.12a | -0.95 | -2.07a | N/A | N/A | N/A | No loss |
Brittingham, 2014[20] | Retrospective | 81 eyes | 28.6 | 12 | 30/3 | 0.1% RF in 20% dex/20 | UV-XTM 2000 | N/A | N/A | -0.8b | -0.76b | N/A | 323b | N/A |
Comparative | 50 eyes | 26.1 | 10/9 | UV-XTM 1000 | N/A | N/A | +0.52b | +0.72b | N/A | 245b | N/A | |||
Shetty, 2015[15] | Prospective | 36/36 | 22.8 (14-33) | 12 | 30/3 | 0.1% RF in 20% dex/30 | Avedro KXL | -0.05a | -0.85a | -1.32a,b | N/A | N/A | 280 | -166a |
Randomized comparative | 36/36 | 23.1 (13-33) | 10/9 | -0.15a | -1a | 0.67a,b | N/A | N/A | 292 | -187a | ||||
Ng, 2016[21] | Retrospective | 14/12 | 36.1 | 12 | 30/3 | 0.1% RF in 20% dex/25 | UV-X 1000 | -0.13a | 0.23 | N/A | -1.8a,b | -2.1 | 282b | N/A |
Comparative | 12/12 | 32.6 | 10/9 | UV-X 2000 | 0.02 | 0.98 | N/A | -0.3b | 2.1 | 209b | N/A | |||
Toker, 2017[19] | Retrospective | 34/34 | 21.1 (13-30) | 12 | 30/3 | 0.1% RF in HPMC/20 | CCL-Vario | -0.11a | 0.96 | -0.74b | -2.15a | N/A | 266 | No loss |
Comparative | 45/45 | 22.4 (14-33) | 10/9 | Avedro KXL | -0.12a | 0.49 | -0.94b | -1.64a | N/A | 273 | No loss | |||
Hagem, 2017[23] | Prospective | 20 eyes | N/A | 12 | 30/3 | 0.1% RF in HPMC/20 | UV-X 1000 | -0.11a | N/A | N/A | -1.4a | N/A | 442b,c | No loss |
Randomized comparative | 20 eyes | 10/9 | UV-X 2000 | -0.09a | N/A | N/A | -0.5 | N/A | 317b,c | No loss | ||||
Baenninger, 2017[16] (pediatric) | Retrospective | 39/31 | 16.3 | 12 | 30/3 | 0.1% RF in 20% dex/30 | UV-X | 0.14 | N/A | N/A | 1.49 | N/A | N/A | N/A |
Comparative | 39/30 | 15.5 | 10/9 | CCL-365 Vario | 0.19 | N/A | N/A | 0.71 | N/A | N/A | N/A | |||
Vounotrypidis, 2018[17] | Retrospective | 131/101 | 26.9 | 36 | 30/3 | 0.1% RF in 20% dex/30 | UV-X 1000 | -0.09 | N/A | N/A | -0.3a | N/A | N/A | N/A |
Comparative | 282/215 | 27.5 | 10/9 | UV-X 2000 | -0.03 | N/A | N/A | -1.4a | N/A | N/A | N/A | |||
Sarac, 2018[18](pediatric) | Retrospective | 38/29 | 15.0 (11-17) | 24 | 30/3 | 0.1% RF in 20% dex/30 | UVA system (Meran Tip) | 0.00 | 0.44 | -0.22 | -0.61 | N/A | N/A | N/A |
Comparative | 49/35 | 14.9 (10-17) | 10/9 | -0.07 | 0.46 | -0.59a | -1.01a | N/A | N/A | N/A | ||||
Our study | Prospective | 32/32 | 24.6 (19-38) | 24 | 30/3 | 0.1% RF in 20% dex/30 | UV-X 1000 | -0.13a | -0.7a | -0.4a,b | -0.9a | -1 | 310b | No loss |
Randomized comparative | 27/27 | 23.1 (18-34) | 10/9 | 0.1% RF in HPMC/10 | Avedro KXL | -0.07a | -0.4a | -0.1b | -0.4a | 10a | 240b | No loss |
N/A: Not applicable. aStatistically significantly different compared to baseline; bStatistically significant difference between CCXL and ACXL (9 mW/cm2) groups; cMeasurement with IVCM.