PURPOSE To determine 2-year efficacy of accelerated corneal cross-linking (CXL) in keratoconus treatment using standard riboflavin-dextran or hypotonic riboflavin solutions. METHODS Patients undergoing accelerated CXL (epitheliumoff 10 minutes, 9 mW/cm2 protocol) with standard riboflavin solution (48 eyes of 48 patients) or hypotonic riboflavin solution (43 eyes of 43 patients) were included and followed up for 2 years. Thinnest corneal thickness (TCT), maximum keratometry, and visual acuity were measured and changes from baseline to postoperative 6, 12, and 24 months were compared between the two groups. RESULTS The preoperative mean TCT with intact epithelium was 472.0 ± 23.9 and 427.5 ± 22.3 µm in the standard riboflavin and hypotonic riboflavin groups, respectively (P < .001). The decreases in the mean TCT values from baseline to postoperative 6 months were similar between the standard riboflavin (from 472 to 436 µm) and hypotonic riboflavin (from 427 to 394 µm) groups. This suggested that the hypotonic riboflavin solution was comparable with the standard riboflavin solution in preserving corneal thickness in keratoconus. There were no significant differences between the study groups regarding the postoperative changes in maximum keratometry or visual acuity. CONCLUSIONS The efficacy of accelerated CXL with hypotonic riboflavin solution was comparable to that with the standard riboflavin solution in reducing keratoconus progression in a 2-year follow-up period. [J Refract Surg. 2020;36(2):110-117.].

中文翻译：

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圆锥角膜治疗中加速角膜交联的长期结果：低渗核黄素溶液与标准核黄素溶液的比较。

目的确定使用标准核黄素-葡聚糖或低渗核黄素溶液在圆锥角膜治疗中加速角膜交联（CXL）的2年疗效。方法纳入接受标准核黄素溶液（48例48眼）或低渗核黄素溶液（43例43眼）的加速CXL（上皮关闭10分钟，9 mW / cm2方案）的患者，并随访2年。测量两组的最薄角膜厚度（TCT），最大角膜曲率法和视敏度，并比较从基线到术后6、12和24个月的变化。结果标准核黄素和低渗核黄素组的术前平均TCT完整上皮分别为472.0±23.9和427.5±22.3 µm（P <.001）。标准核黄素（从472到436 µm）和低渗核黄素（从427到394 µm）组之间，从基线到术后6个月的平均TCT值下降相似。这表明低渗核黄素溶液在保留圆锥角膜的角膜厚度方面与标准核黄素溶液相当。在最大角膜曲率或视力的术后变化方面，研究组之间无显着差异。结论在2年的随访期内，低渗核黄素溶液加速CXL的效果与标准核黄素溶液加速CXL的效果相当。[J Refract Surg。2020; 36（2）：110-117。]。