Aydin Fahri Onur, Bağatur Vurgun Elif, Özkan Gamze, Akkaya Turhan Semra, Toker Ebru
Department of Ophthalmology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir Olympic Boulevard Road, Basaksehir, Istanbul, Turkey.
Kocaeli Kandıra M. Kazım Dinç State Hospital, Kandıra, Kocaeli, Turkey.
Int Ophthalmol. 2025 Aug 13;45(1):334. doi: 10.1007/s10792-025-03707-y.
To compare the 24-month outcomes of accelerated contact lens-assisted corneal crosslinking (A-CACXL) in thin corneas (< 400 microns) versus conventional accelerated CXL (A-CXL) in progressive keratoconus patients.
This study included progressive keratoconus patients who underwent A-CACXL (9 mW/cm for 10 min) and A-CXL (9 mW/cm for 10 min). A-CACXL was performed in cases with the thinnest corneal thickness of 400 μm or less. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), keratometric, tomographic, aberrometric values, and Regularization Index (RI) were compared at a 2-year follow-up.
The study enrolled 41 eyes; 20 eyes underwent A-CACXL and 21 eyes underwent A-CXL. Preoperative BSCVA, Kmax, K1, and K2 values were similar in both groups (p > 0.05). Preoperative thinnest corneal pachymetry measurements were significantly less in A-CACXL group (384.8 ± 25.2 vs. 450.4 ± 35.7; p < 0.001). ΔBSCVA, RI, and ΔKmax were similar in A-CACXL and A-CXL groups (- 0.14 ± 0.27 vs. - 0.17 ± 0.18; 5.9 D ± 4.9 D vs. 4.6 D ± 2.5 D; - 2.0 ± 3.5 D vs. - 2.0 ± 3.1 D; respectively). A-CACXL showed 95% of eyes halting progression, with 60% showing regression, similar to A-CXL (57.1% regression, 100% halting progression) (p = 0.521). In the A-CACXL group, curvature-based index (ARC) improved significantly (p = 0.002), pachymetric indices (ARTmax, RPIavg) worsened significantly (p = 0.002, 0.026), while no change was observed in aberrometric parameters (p > 0.05).
In eyes with thin corneas and progressive keratoconic condition, the safety and effectiveness of A-CACXL seemed comparable to that of A-CXL at the 2-year follow-up. Both techniques yielded similar visual, keratometric, tomographic, and aberrometric results.
比较进展性圆锥角膜患者中薄角膜（<400微米）行加速角膜接触镜辅助角膜交联术（A-CACXL）与传统加速角膜交联术（A-CXL）的24个月疗效。
本研究纳入了行A-CACXL（9毫瓦/平方厘米，持续10分钟）和A-CXL（9毫瓦/平方厘米，持续10分钟）的进展性圆锥角膜患者。角膜最薄处厚度为400μm或更薄的患者行A-CACXL。在2年随访时比较术前和术后最佳矫正视力（BSCVA）、角膜曲率、断层扫描、像差测量值和规则化指数（RI）。
该研究纳入41只眼；20只眼行A-CACXL，21只眼行A-CXL。两组术前BSCVA、Kmax、K1和K2值相似（p>0.05）。A-CACXL组术前最薄角膜厚度测量值显著更低（384.8±25.2 vs. 450.4±35.7；p<0.001）。A-CACXL组和A-CXL组的ΔBSCVA、RI和ΔKmax相似（分别为-0.14±0.27 vs. -0.17±0.18；5.9 D±4.9 D vs. 4.6 D±2.5 D；-2.0±3.5 D vs. -2.0±3.1 D）。A-CACXL显示95%的眼病情停止进展，60%的眼病情有改善，与A-CXL相似（57.1%改善，100%病情停止进展）（p=0.521）。在A-CACXL组中，基于曲率的指数（ARC）显著改善（p=0.002），厚度指数（ARTmax，RPIavg）显著恶化（p=0.002，0.026），而像差参数无变化（p>0.05）。
在薄角膜且患有进展性圆锥角膜的眼中，在2年随访时A-CACXL的安全性和有效性似乎与A-CXL相当。两种技术产生的视觉、角膜曲率、断层扫描和像差结果相似。
