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Accelerated transepithelial corneal cross-linking for progressive keratoconus: a prospective study of 12 months
  1. Wei Aixinjueluo1,
  2. Tomohiko Usui1,
  3. Takashi Miyai1,
  4. Tetsuya Toyono1,
  5. Toshihiro Sakisaka1,
  6. Satoru Yamagami2
  1. 1 Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  2. 2 Division of Ophthalmology, Department of Visual Sciences, Nihon University, Chiyoda-ku, Japan
  1. Correspondence to Dr Wei Aixinjueluo, Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Japan, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan; waixinjueluo{at}


Background/aims To evaluate the clinical results of accelerated transepithelial corneal cross-linking (CXL) in Japanese patients with progressive keratoconus (KCN).

Methods Thirty eyes of 19 patients (16 male, 3 female patients) with progressive KCN were included. The mean age was 24.9±7.0 (range 16–38) years. All patients received ultraviolet A radiation for 3 min at an irradiance of 30 mW/cm2. Patients were followed up on the first day, at 1 week and 2 weeks, and at 1 month, 3 months, 6 months and 12 months postoperatively. Clinical examinations included measures of uncorrected visual acuity, best corrected visual acuity (BCVA), average keratometry (AveK), maximum keratometry (Kmax), central corneal thickness, thinnest corneal thickness (TCT), endothelial cell density, intraocular pressure and non-mydriatic indirect fundus examination. Patients were asked to report any pain or discomfort at each visit.

Results There were no intraoperative or postoperative complications. All 30 eyes finished the follow-up. After 12 months, there was a significant decrease in Kmax (p<0.0001), AveK (p=0.003) and TCT (p=0.002), and a significant improvement in BCVA (p=0.001). There were no other significant changes. Pain or foreign-body sensation following CXL appeared in the first 2 days, but lasted no more than 1 week in all cases.

Conclusions There were no complications associated with accelerated transepithelial corneal CXL, and the clinical outcomes were appraisable in a 12-month follow-up.

Trial registration number UMIN000009372.

  • Cornea
  • Optics and Refraction
  • Treatment Surgery

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  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript. Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in British Journal of Ophthalmology.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Board of The University of Tokyo Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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