{"title":"Comparison of the 1-year efficacy of epithelium-off and transepithelial accelerated corneal collagen crosslinking in adolescent keratoconus.","authors":"Yuhong Tang, Jinling Jiang, Chaoju Yang, Hongyu Yin, Yunzhen Fei","doi":"10.1038/s41433-025-03784-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To compare the clinical efficacy of epithelium-off and transepithelial accelerated corneal collagen crosslinking (ACXL) in adolescent keratoconus.</p><p><strong>Methods: </strong>In this prospective observational study with a 1-year follow-up, 60 patients aged 16-26 years (60 eyes) with keratoconus were assigned to two groups: the epithelium-off ACXL group (30 patients, 30 eyes) and the transepithelial ACXL group (30 patients, 30 eyes). Patients were evaluated preoperatively and at 7 days, 1 month, 3 months, 6 months, and 12 months post-treatment. The measurements included visual acuity, corneal parameters, and corneal endothelium parameters. Baseline data and treatment effect were compared using the t-test or Wilcoxon rank-sum test for continuous variables and the chi-square test for categorical variables. Within-group comparisons used paired t-tests or paired rank-sum tests.</p><p><strong>Results: </strong>At 12 months postoperatively, the treatment groups showed statistically significant differences in central corneal thickness (IOLMaster), thinnest point corneal thickness (topography), thickness (topography), central corneal thickness, corneal thickness on optical coherence tomography, deformation amplitude (DA), first applanation time, first applanation velocity, second applanation time, second applanation velocity, peak distance (PD), high-contrast acuity, stiffness parameter at the first applanation, and comprehensive refraction (p < 0.001). No differences were observed between the groups in any other parameters before or after treatment.</p><p><strong>Conclusions: </strong>Both epithelium-off and transepithelial ACXL effectively treat keratoconus. Transepithelial ACXL is slightly inferior to epithelium-off ACXL in maximum corneal curvature but superior in improving corneal thickness and DA parameters. Further studies are necessary to verify the efficacy, safety, and long-term stability of transepithelial ACXL in treating keratoconus.</p>","PeriodicalId":12125,"journal":{"name":"Eye","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eye","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41433-025-03784-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To compare the clinical efficacy of epithelium-off and transepithelial accelerated corneal collagen crosslinking (ACXL) in adolescent keratoconus.
Methods: In this prospective observational study with a 1-year follow-up, 60 patients aged 16-26 years (60 eyes) with keratoconus were assigned to two groups: the epithelium-off ACXL group (30 patients, 30 eyes) and the transepithelial ACXL group (30 patients, 30 eyes). Patients were evaluated preoperatively and at 7 days, 1 month, 3 months, 6 months, and 12 months post-treatment. The measurements included visual acuity, corneal parameters, and corneal endothelium parameters. Baseline data and treatment effect were compared using the t-test or Wilcoxon rank-sum test for continuous variables and the chi-square test for categorical variables. Within-group comparisons used paired t-tests or paired rank-sum tests.
Results: At 12 months postoperatively, the treatment groups showed statistically significant differences in central corneal thickness (IOLMaster), thinnest point corneal thickness (topography), thickness (topography), central corneal thickness, corneal thickness on optical coherence tomography, deformation amplitude (DA), first applanation time, first applanation velocity, second applanation time, second applanation velocity, peak distance (PD), high-contrast acuity, stiffness parameter at the first applanation, and comprehensive refraction (p < 0.001). No differences were observed between the groups in any other parameters before or after treatment.
Conclusions: Both epithelium-off and transepithelial ACXL effectively treat keratoconus. Transepithelial ACXL is slightly inferior to epithelium-off ACXL in maximum corneal curvature but superior in improving corneal thickness and DA parameters. Further studies are necessary to verify the efficacy, safety, and long-term stability of transepithelial ACXL in treating keratoconus.
期刊介绍：
Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists.
Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.
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