P-23 Efficacy and safety of accelerated trans-epithelial iontophoretic corneal collagen cross-linking (accelerated i-CXL-TE) in young patients with progressive keratoconus: 9-year follow-up
Year: 2025
Type: conference-abstract
Abstract: Purpose To evaluate the long-term efficacy and safety of Accelerated i-CXL-TE in paediatric and young adult patients with progressive keratoconus (pKC), reporting clinical outcomes and side effects over a 9-year follow-up.Methods Sixty-nine eyes from 56 patients aged 12 - 32 years with documented keratoconus progression (Kmax increase >1.5D, pachymetric reduction >20 µm, or increased cylindrical correction >0.75D within 12 months) were treated with Accelerated i-CXL-TE from January to December 2015. The procedure involved riboflavin imbibition with a 0.1% hypotonic riboflavin solution (Ricrolin Plus®) using iontophoresis for 5 minutes, followed by UV-A irradiation at 10 mW/cm² for 9 minutes. Clinical and tomographic assessments were performed at 1, 3, and 6 months and every 6 months for 9 years, with annual endothelial counts and OCT evaluations.Results Kmax showed a progressive and statistically significant reduction from the 6th month onward (p<0.05), with mean decreases of 0.56±0.81, 0.63±0.89, 0.98±0.92, 1.27±1.11, 1.19±1.12, 1.06±1.12, 1.11±1.14, 1.02±1.19, 0.99±1.07, 0.96±1.03, 1.02±1.08 at 3, 6, 12, 24, 36, 48, 60, 72, 84, 96, 108 months, respectively. A significant visual acuity gain was reported in 62/69 eyes (89.9%) at 9 years. Pachymetry, endothelial counts, intraocular pressure, and OCT findings remained stable throughout. Retreatment was required in 4 eyes (5.8%), resulting in subsequent stabilisation. No corneal haze or adverse effects were observed.Conclusions Accelerated i-CXL-TE demonstrated long-term efficacy in halting keratoconus progression. The short procedure time and excellent safety profile make it particularly suitable for paediatric patients.
Authors: Mario Troisi, Salvatore Troisi, Ciro Costagliola, Vito Romano
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4412406683