| Study | Study design/ Indication/ Protocol | No. of eyes | Follow-up, months | Criteria for Progression | UV device/ Riboflavin | Protocol | Outcome | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall | Pre-op K (D) | ΔK (D) | Δ UCVA | Δ BCVA | Δ Refraction (D) | |||||||
| Gatzioufas et al, 2013 [52] | Prospective cohort study/ Keratoconus | 7 | 6 | Mean of 3 consecutive measurements showing ↑ Kmax > 1D/ 12 months | CXL-365 Vario/ 0.1% riboflavin with 20% dextran 30 min | 18mW/cm2 5 min | Kmax, Kmean and CDVA showed no significant changes after 6 months. No complications were observed postoperatively. | Kmax: 55.6 ± 3.8 | From 55.6 ± 3.8 to 52.9 ± 2.7 (P = 0.42) | - | From 0.41 ± 0.34 to 0.58 ± 0.37 (LogMAR) (P = 0.055) | - |
| Shetty et al, 2014 (paeds) [63] |
Prospective case series/ Keratoconus | 30 | 24 | ↑ steep K >1.0-1.5D and Δ in subjective refraction/ 6 months or ↓ ≥5% in thinnest pachymetry/ 6 months |
Avedro KXL/ 0.1% riboflavin with 20% dextran for 30 min | 9mW/cm2 for 10 min | Improved mean UDVA, mean CDVA, mean spherical refraction, mean cyl, and SE | Max K: 53.77 ± 4.82 | From 53.77 ± 4.82 to 51.70 ± 5.41 (P = 0.007) | From 0.76 ± 0.26 to 0.61 ± 0.25 (LogMAR) (P = 0.005) | From 0.24 ± 0.19 to 0.12 ± 0.12 (LogMAR) (P < 0.001) | Mean SE: from -4.70 ± 3.86 to -3.75 ± 3.49 (P = 0.15) |
| Marino et al, 2015 [64] | Prospective, single-center case series/ Post-laser ectasia | 40 | 24 | 1. ↑ inferior steepening 2. ↑ myopia and astigmatism 3. ↓ UDVA and CDVA |
CCL-Vario Crosslinking; Peschke Meditrade GmcH/ 0.1% riboflavin 30 min | 9mW/cm2 for 10 min | All eyes stabilised after treatment without any further signs of progression. | Max K: 48.89 ± 2.85 | From 48.89 ± 2.85 to 49.21 ± 3.15 (P = 0.956) | From 0.33 ± 0.18 to 0.37 ± 0.18 (LogMAR) (P = 0.649) | From 0.13 ± 0.10 to 0.15 ± 0.12 (LogMAR) (P = 0.616) | - |
| Ozgurhan et al, 2014 (paeds) [65] |
Retrospective interventional case series/ Keratoconus | 44 | 24 | ↑ Kmax of ≥ 1D, ↑ astigmatism by ≥ 1D or ↑ MRSE of 0.50D/ 3 months | Avedro KXL/ 0.1% riboflavin 15 min | 30mW/cm2 for 4 min | Improved UDVA and CDVA. Flat K value and steep K value decreased. | Max K: 50.6 ± 4.2 | From 50.6 ± 4.2 to 50.1 ± 4.0 (P < 0.001) | From 0.52 ± 0.36 to 0.39 ± 0.26 (LogMAR) (P = 0.002) | From 0.38 ± 0.24 to 0.30 ± 0.20 (LogMAR) (P < 0.001) | SE: From -5.45 ± 2.99 to 5.27 ± 2.91 (P = 0.205) |
| Moramarco et al, 2015 [66] | Retrospective case series/ Keratoconus | 60 | 1 | Δ in corneal curvature in the cone area of ≥ 1.0 D or thinning of > 10μm in minimal pachymetry in 2 consecutive topography maps/ 6 months | Avedro KXL I/ 0.1% riboflavin with 1% HPMC 10 min | Pulsed: 30mW/cm2 8 min Continuous: 30mW/cm2 4 min |
Pulsed accelerated CXL had a significantly deeper demarcation line as compared to continuous light exposure. | Max K (pulsed): 47 ± 6 Max K (continuous): 48.6 ± 3.8 (P > 0.05) |
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