PURPOSE To compare the clinical and tomographic properties of adult patients with keratoconus treated with accelerated corneal cross-linking (A-CXL) versus accelerated contact lens-assisted corneal cross-linking (A-CACXL). METHODS Patients who underwent A-CXL and A-CACXL due to progressive keratoconus were enrolled from January 2015 to January 2018 in this retrospective case-control study. The treatment group (minimum corneal thickness of less than 400 µm after epithelium removal; 30 patients, 30 eyes) was treated with A-CACXL; the control group (minimum corneal thickness of 400 µm or greater, 32 patients, 32 eyes) was treated with A-CXL. Assessments occurred before treatment and 12 months postoperatively. Demographic, clinical, and tomographic data were obtained from outpatient clinic reports. RESULTS Significant improvement in visual acuity was evident at 12-month follow-up for the control group in uncorrected distance visual acuity (0.62 ± 0.42 vs 0.43 ± 0.31 logMAR, P = .01) and the treatment group in corrected distance visual acuity (0.51 ± 0.30 vs 0.40 ± 0.49 logMAR, P = .03). Progression of keratoconus was halted at similar rates for both groups (76.7% treatment, 84.4% control, P = .21). Mean minimum corneal thickness showed minor but significant thinning at the 12-month follow-up visit compared to baseline (control group = 463 ± 31 vs 450 ± 35 µm, P > .01; treatment group = 398 ± 32 vs 388 ± 41 µm, P = .02). CONCLUSIONS A-CACXL halted keratoconus progression in 76.7% of eyes and achieved regression in 33.3% of eyes, with rates comparable to A-CXL. Visual outcomes improved for both groups, with similar keratometry changes. A-CACXL is an effective and safe option for patients with keratoconus and thin corneas, with results similar to A-CXL treatment in patients with a minimum corneal thickness of 400 µm or greater. [J Refract Surg. 2021;37(9):623-630.].

中文翻译：

---

成人渐进性圆锥角膜的加速 CXL 与加速隐形眼镜辅助 CXL。

目的 比较接受加速角膜交联 (A-CXL) 与加速隐形眼镜辅助角膜交联 (A-CACXL) 治疗的成人圆锥角膜患者的临床和断层扫描特性。方法 本回顾性病例对照研究于 2015 年 1 月至 2018 年 1 月招募了因进行性圆锥角膜而接受 A-CXL 和 A-CACXL 治疗的患者。治疗组（上皮切除后角膜厚度小于400μm；30例，30只眼）采用A-CACXL治疗；对照组（最小角膜厚度为 400 µm 或更大，32 名患者，32 只眼）接受 A-CXL 治疗。评估发生在治疗前和术后 12 个月。人口统计学、临床和断层摄影数据来自门诊报告。结果 在 12 个月的随访中，对照组的未矫正远视力（0.62 ± 0.42 vs 0.43 ± 0.31 logMAR，P = .01）和治疗组矫正远视力（0.51 ± 0.30 与 0.40 ± 0.49 logMAR，P = .03）。两组的圆锥角膜进展以相似的速度停止（治疗 76.7%，对照组 84.4%，P = .21）。与基线相比，在 12 个月的随访中，平均最小角膜厚度显示轻微但显着变薄（对照组 = 463 ± 31 vs 450 ± 35 µm，P > .01；治疗组 = 398 ± 32 vs 388 ± 41 µm , P = .02)。结论 A-CACXL 阻止了 76.7% 眼睛的圆锥角膜进展，并在 33.3% 的眼睛中实现了消退，其发生率与 A-CXL 相当。两组的视力结果都有所改善，角膜曲率变化相似。对于圆锥角膜和薄角膜患者，A-CACXL 是一种有效且安全的选择，对于最小角膜厚度为 400 µm 或更大的患者，其结果与 A-CXL 治疗相似。[J 屈光手术。2021;37(9):623-630.]。