IS ACCELERATED CONTACT LENS-ASSISTED CROSS-LINKING (ACACXL) SAFE AND EFFECTIVE IN PATIENTS WITH CORNEA THICKNESS LESS THAN 400 MICRONS OR SHOULD ALTERNATIVE METHODS BE CONTINUED TO BE EXPLORED?

This study aimed to evaluate the effectiveness, safety, and reliability of contact lens-assisted cross-linking surgery using an alternative contact lens material in accelerated corneal collagen cross-linking, a viable option for patients with thin corneas.

University of Health Sciences, Gaziosmanpasa Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey

This study was designed retrospectively and included 28 eyes from 23 patients diagnosed with progressive keratoconus who underwent accelerated contact lens-assisted cross-linking. A key common feature among these patients, which justified their inclusion in the study, was that they had thin corneas with a thickness of 400 microns or less after epithelial debridement. The patients were followed regularly over a period of 6 months, with the primary outcome measures being uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), manifest sphere(D) and manifest cylinder(D) refraction values, K1(D), K2(D), Kmax(D), mean keratometry(D) values, minimum corneal thickness(μm). Statistical analysis of these outcome measures was performed at baseline and at 1, 3, and 6 months postoperatively. 

A total of 28 eyes of 23 patients who were diagnosed with progressive keratoconus with corneal thickness 400 micron or below were included. The results showed a statistically significant improvement in best-corrected visual acuity (BCVA), highlighting the effectiveness of the treatment (p:0,004). There is no statistically significant change in UDVA, K1, mean
manifest sphere value, minimum corneal thickness  .(respectively p:0.427, p: 0.591, p:0.490, p:0.153). There is a statistically significant decrease in the Kmax, K2, mean keratometry and mean manifest cylinder values.(respectively p: 0.003, p < 0.001, p : 0.028, p:0.048).

The A-CACXL technique is a reliable and effective approach for halting the progression of keratoconus and enhancing functional vision in patients with corneal thickness 400 micron and below.Neverthelessmore extensive randomized controlled  trials are necessary to confirm these results.