• George D Kymionis, Konstantinos I Tsoulnaras, Michael A Grentzelos, Dimitrios A Liakopoulos, Nikolaos G Tsakalis, Styliani V Blazaki, Theodoros A Paraskevopoulos, and Miltiadis K Tsilimbaris.
• Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida. Electronic address: kymionis@med.uoc.gr.
• Am. J. Ophthalmol. 2014 Oct 1; 158 (4): 671-675.e1.

PurposeTo compare the corneal stromal demarcation line depth using anterior segment optical coherence tomography (AS-OCT) after corneal collagen cross-linking (CXL) using 2 different treatment protocols: the standard Dresden protocol (30 minutes with 3 mW/cm(2)) and a modified-accelerated protocol (14 minutes with 9 mW/cm(2)).DesignProspective, comparative study.MethodsForty-three keratoconic patients (52 eyes) were enrolled. All patients underwent CXL using the same high-intensity ultraviolet-A (UV-A) irradiation device. Twenty-six eyes were treated for 30 minutes with 3 mW/cm(2) according to the standard Dresden protocol (Group 1), while 26 eyes were treated with a novel modified-accelerated CXL protocol for 14 minutes with 9 mW/cm(2) of UV-A irradiation intensity (Group 2). One month postoperatively, corneal stromal demarcation line depth was measured by 2 independent observers using AS-OCT.ResultsCorneal stromal demarcation line depth was assessed with no significant difference between observer measurements for both groups (P = .676 for Group 1 and P = .566 for Group 2). Mean corneal stromal demarcation line depth was 337.00 ± 46.46 μm for Group 1 and 322.91 ± 48.28 μm for Group 2. There was no statistically significant difference (P = .243) in the corneal stromal demarcation line depth between the 2 groups.ConclusionsCorneal stromal demarcation line depth using UV-A with 3 mW/cm(2) for 30 minutes and 9 mW/cm(2) for 14 minutes was similar. A modified-accelerated protocol of 14 minutes of CXL provided the same treatment depth as the classic Dresden protocol.Copyright © 2014 Elsevier Inc. All rights reserved.

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