Accelerated Pulsed High-Fluence Corneal Cross-Linking for Progressive Keratoconus

Participants: Age ≥ 16yo, progressive keratoconus

• n=1192 eyes (870 patients)

Intervention:

-Riboflavin 0.1% soak duration for 10 minutes.
-High-fluence pulsed UVA delivered at 30 mW/cm2 for 4 minutes, with a 1.5-second on/off cycle (total energy 7.2 J/cm2)

In mild cones group (Kmax < 55 dioptres), mean keratometry was unchanged at 2 years

In advanced cones group (Kmax ≥ 55 D), there was modest corneal flattening but no significant change in central keratometry when compared to baseline.

There was keratometric stabilisation in 98.3% of eyes

There was no change in mean CDVA, manifest refraction and endothelial cell density