Corneal stromal demarcation line after accelerated crosslinking using continuous and pulsed light

Antonio Moramarco, Alfonso Iovieno, Antonio Sartori, Luigi Fontana

Research output: Contribution to journalArticlepeer-review


Purpose To evaluate and compare the depth of corneal stromal demarcation line after accelerated collagen crosslinking (CXL) using continuous and pulsed light ultraviolet-A (UVA) exposure. Setting Department of Ophthalmology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Design Retrospective case series. Methods Patients with progressive keratoconus were assigned to 1 of 2 treatment protocols using the same irradiation device for accelerated CXL. Patients assigned to Group A received accelerated CXL using continuous UVA light exposure at 30 mW/cm2 for 4 minutes. Patients assigned to Group B received accelerated CXL using pulsed UVA light with 8 minutes (1 second on/1 second off) of UVA exposure at 30 mW/cm2 and energy dose of 7.2 J/cm2. One month after surgery, corneal stromal demarcation line depth was measured by 2 independent observers using anterior segment optical coherence tomography (AS-OCT). Results A total of 60 patients were assessed. Corneal stromal demarcation line was easily identified on AS-OCT scans in all eyes by both observers. The mean depth of stromal demarcation line was 149.32 ± 36.03 μm in Group A and 213 ± 47.38 μm in Group B. The difference in stromal demarcation line depth between groups was statistically significant (P <.001). Conclusions Using accelerated CXL, the corneal stromal demarcation line was significantly deeper using pulsed rather than continuous light exposure.

Original languageEnglish
Pages (from-to)2546-2551
Number of pages6
JournalJournal of Cataract and Refractive Surgery
Issue number11
Publication statusPublished - Nov 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Ophthalmology
  • Sensory Systems


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