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Systematic review and Meta-analysis comparing modified cross-linking and standard cross-linking for progressive keratoconus. | LitMetric

Systematic review and Meta-analysis comparing modified cross-linking and standard cross-linking for progressive keratoconus.

Int J Ophthalmol

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100005, China.

Published: September 2017

AI Article Synopsis

  • - The study aims to compare the effectiveness and safety of modified cross-linking (MC) versus standard cross-linking (SC) in treating mild to moderate progressive keratoconus.
  • - Twenty-four studies were analyzed, showing that SC significantly outperformed MC in delaying deterioration of the corneal shape (Kmax) and improving spherical equivalent (SE) values.
  • - While SC proved better at halting keratoconus progression, the improvement in visual acuity was similar for both MC and SC treatments.

Article Abstract

Aim: To compare the effectiveness and safety between modified cross-linking (MC) and standard cross-linking (SC) in mild or moderate progressive keratoconus.

Methods: Eligible studies were retrieved from four electronic databases, including CENTRAL, Clinical Trials gov, PupMed and OVID MEDLINE. We set post-surgical maximum K value (Kmax) as the primary outcome. In addition, uncorrected and corrected distant visual acuity (UDVA and UDVA), spherical equivalent (SE), endothelial cell density (ECD), central cornea thickness (CCT) and depth of demarcation line (DDL) were Meta-analyzed as secondary outcomes. Mean differences for these outcomes were pooled through either a random-effect model or fixed-effect model according to data heterogeneity.

Results: Twenty-four comparative studies either on accelerated cross-linking (AC) compared with SC or on trans-epithelial cross-linking (TC) compared with SC were included and pooled for analysis. The results indicated that MC was significantly inferior to SC at delaying Kmax deterioration [AC SC 0.49 (95% CI: 0.04-0.94, =75%, =0.03); TC SC 1.15 (95% CI: 0.54-1.75, =50%, =0.0002)]. SE decreased significantly for SC when compared to AC [0.62 (95% CI: 0.38-0.86, =22%, <0.00001)]. DDL of SC was more significantly deeper than that of TC [-133.49 (95% CI: -145.94 to -121.04, =33%, <0.00001)]. Other outcomes demonstrated comparable results between MC and SC.

Conclusion: SC is more favorable at halting the progression of keratoconus, but visual acuity improvement showed comparable results between MCs and SC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596229PMC
http://dx.doi.org/10.18240/ijo.2017.09.15DOI Listing

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