Accelerated Corneal Collagen Cross-Linking Using Topography-Guided UV-A Energy Emission: Preliminary Clinical and Morphological Outcomes

Figure 5

Topography-guided ACXL treatment programs according to different KC severity. (a) shows a 3-Zone topography-guided ACXL treatment planning according to corneal curvatures. Postoperative OCT scans one month after treatment (b) revealed a triple demarcation line according to the three different exposure times and energy doses: 7.2 J/cm² in the peripheral KC flattest area 48 D and under (depth 151 µm), green arrows (8 min UV-A exposure); 10 J/cm² in the intermediate area between 48 and 52 D (depth 215 µm), blue arrows (11 min UV-A exposure); 15 J/cm² in the steepest area (depth 310 µm), red arrows (16 min UV-A exposure). (c) shows a 2-Zone topography-guided ACXL treatment with 7.2 (green arrows) and 10 J/cm² (blue arrows) doses treatment planning. OCT scan performed one month after treatment (d) revealed a double demarcation line according to the different exposure times and doses delivered according to corneal curvatures, reaching a demarcation line depth of 164 µm in the peripheral area treated with 7.2 J/cm² for 8 min of UVA exposure (green arrow) and 311 µm in the steeper paracentral area treated with 10 J/cm² for 11 min of UV-A exposure (blue arrow).