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Accelerated Versus Conventional Corneal Collagen Cross-Linking in the Treatment of Keratoconus: A Meta-analysis and Review of the Literature

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Abstract

Aim

Our aim was to examine existing literature, and determine if there are outcome differences between accelerated corneal collagen cross-linking (A-CXL) and conventional corneal collagen cross-linking (C-CXL).

Methods

A systematic review of the literature was conducted examining studies which compared A-CXL to C-CXL. Available studies were combined and the weighted mean difference (WMD) was calculated for range of outcome measures including maximal keratometry (Kmax), mean keratometry (Kmean) and minimum keratometry (Kmin), spherical equivalent, best corrected visual acuity (BCVA), and central corneal thickness (CCT).

Results

Seven eligible studies were included in our meta-analysis, with 283 eyes (135 in A-CXLand 148 in C-CXL). In the combined analysis, there was no statistically significant difference observed in Kmin or Kmax between A-CXL and C-CXL for at least 6 months after the procedure. Kmean was statistically higher in the C-CXL group in comparison with the A-CXL group for at least 6 months after the procedure (WMD − 3.15, 95% CI − 4.34 to − 1.97, p < 0.01).No statistically significant difference observed in spherical equivalent or central corneal thickness between the A-CXL group and C-CXL group for at least 6 months after the operation. The BCVA was statistically higher in the A-CXL group in comparison with the C-CXL group for at least 6 months after the procedure (WMD − 0.05, 95% CI 0.00–0.10, p < 0.05). No surgery complication was recorded in the researches.

Conclusion

Our study demonstrated greater reductions of Kmean in the A-CXL group in comparison with the C-CXL group. Overall A-CXL is comparable to C-CXL from outcome basis.

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Funding

Supported by the National Natural Science Foundation of China (Grant No. 81170826).

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Authors and Affiliations

  1. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Yang Jiang, Shan Yang, Ying Li & Ge Cui

  2. St George Hospital, Gray Street, Kogarah, NSW, 2217, Australia

    Thomas Chengxuan Lu

Authors
  1. Yang Jiang
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  2. Shan Yang
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  3. Ying Li
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  4. Ge Cui
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  5. Thomas Chengxuan Lu
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Contributions

JY and YS conducted a systematic literature search and analyzed the patient data. JY, YS, TCXL, CG, and LY were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ying Li.

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Conflict of interest

The authors declare that they have no competing interests.

Availability of data and material

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Cite this article

Jiang, Y., Yang, S., Li, Y. et al. Accelerated Versus Conventional Corneal Collagen Cross-Linking in the Treatment of Keratoconus: A Meta-analysis and Review of the Literature. Interdiscip Sci Comput Life Sci 11, 282–286 (2019). https://doi.org/10.1007/s12539-019-00336-9

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