Evaluation of corneal stromal demarcation line after two different protocols of accelerated corneal collagen cross-linking procedures using anterior segment optical coherence tomography and confocal microscopy

Abstract

Purpose. To evaluate the depth of corneal stromal demarcation line using AS-OCT and confocal microscopy after two different protocols of accelerated corneal collagen cross-linking procedures (CXL). Methods. Patients with keratoconus were divided into two groups. Peschke CXL device (Peschke CCL-VARIO Meditrade GmbH) applied UVA light with an intended irradiance of 18.0 mW/cm2 for 5 minutes after applying riboflavin for 20 minutes (group 1) and 30 minutes (group 2). One month postoperatively, corneal stromal demarcation line was measured using AS-OCT and confocal microscopy. Results. This study enrolled 34 eyes of 34 patients (17 eyes in group 1 and 17 eyes in group 2). The mean depth of the corneal stromal demarcation line was 208.64 ± 18.41 μm in group 1 and 240.37 ± 18.89 μm in group 2 measured with AS OCT, while it was 210.29 ± 18.66 μm in group 1 and 239.37 ± 20.07 μm in group 2 measured with confocal microscopy. Corneal stromal demarcation line depth measured with AS OCT or confocal microscopy was significantly deeper in group 2 than group 1 (P < 0.01). Conclusion. The group in which riboflavin was applied for 30 minutes showed significantly deeper corneal stromal demarcation line than the group in which riboflavin was applied for 20 minutes.