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International Journal
of Ophthalmology
2017; 10(9): 1419-1429
·Meta-Analysis·
|
Region |
Study design |
Group |
Eye/ patient (n) |
Age (a) |
Gender (M/F) |
Baseline balance (Y/N) |
Follow-up (mo) |
Definition for progressive keratcous |
Intensity (mW/cm2) |
Duration (min) |
Wave legth (nm) |
Riboflavie |
Apparatus |
|
|
France |
PCS |
SC TC AC |
15/15 15/15 15/15 |
25.4±5.6 32.4±6.6 26.7±6.2 |
12/3 11/4 9/6 |
N |
6 |
Kmax≥0.75
D/ 3mo, AST ≥0.75
D/12mo, CCT↓≥30 μm/ 6mo |
3.0 10 30 |
30 9 5 |
370 NA NA |
Ri 0.1% in
20% dex |
X-Vega
(Sooft, SPA) |
|
|
China |
PCS |
SC AC |
19/32 19/32 |
27.8±10.9 26.3±3.7 |
13M 12M |
N |
12 |
Kmax≥1
D/1y, AST≥1 D/1y |
3.0 18 |
30 5 |
365 365 |
Ri 0.1% in 20% dex |
UV-X CCL- Vario |
|
|
Turkey |
PCS |
SC AC |
13/13 13/13 |
17.0±2.7 18.8±4.5 |
6/7 2/11 |
Y |
6 |
Kmax≥1
D/1y, CDVA≥1/2y |
3.0 9 |
30 10 |
NA NA |
Ri 0.1% in 20% dex |
Vega CBM X CCL-Vario |
|
|
Ireland |
RCS |
SC AC |
66/53 36/34 |
30.0±8.00 27.9±7.6 |
39/14 28/6 |
NA NA |
12 |
Kmax≥1
D/2y, ASTIG≥1 D/2y, SE≥0.5 D/3y |
3 9 |
30 10 |
365 365 |
Ri 0.1% in 0-20%
dex |
UV-X 1000 lamp |
|
|
Iran |
RCT |
SC AC |
31/31 31/31 |
25.13±4.21 |
18/13 |
NA NA |
18 |
Kmax≥1
D/y, AST≥1 D/y, VA↓≥2
line/y |
3 18 |
30 5 |
370 370 |
Ri 0.1% in 20% dex |
UV-X
system |
|
|
Iran |
RCT |
SC AC |
76/76 77/77 |
22.3±4 22.6±4 |
38/38 32/45 |
Y |
15 |
Kmean≥1.5
D/ 6mo, CCT↓≥5% |
3 30 |
30 3 |
365 365 |
Ri 0.1% in 20% dex |
CCL- Vario |
|
|
Greece |
RCT |
SC AC |
21/21 21/21 |
NA NA |
NA NA |
NA NA |
48 |
Kmax≥1 D/y |
3 7 |
30 15 |
370 370 |
Ri 0.1% |
NA NA |
|
|
Greece |
PCS |
SC AC |
16/29 16/29 |
27.56±6.20 25.06±6.34 |
22/7 |
Y |
1 |
Kmax≥0.75
D/ 6mo, SE≥0.75
D/6mo |
3 18 |
30 7 |
365 365 |
Ri 0.1% in 20% dex |
CCL-365 |
|
|
Greece |
PCS |
SC AC |
26/43 26/43 |
26.15±6.32 26.23±6.9 |
34/9 |
Y |
1 |
NA NA |
3 9 |
30 14 |
NA NA |
Ri 0.1% in 20% dex |
UV-A
illuminator |
|
|
China |
RCS |
SC AC |
14/12 12/12 |
36.1±10.7 32.6±6.6 |
13/1 9/3 |
Y |
13.9±6.3 |
Kmax≥1 D/ 6mo, AST≥1
D/ 6mo |
3 9 |
30 10 |
NA NA |
Ri 0.1% in 20% dex |
UV-X 1000 UV-X 2000 |
|
|
China |
RCS |
SC AC |
18/17 15/14 |
32.8±9.3 33.0±6.1 |
16/2 12/3 |
Y |
1 |
Kmax≥1 D/ 12mo,
ASTIG ≥1 D/12mo,
SE≥0.5 D/12mo |
3 9 |
30 10 |
NA NA |
Ri 0.1% in 20% dex |
UV-X 1000 UV-X 2000 |
|
|
Eygpt |
RCT |
SC AC |
11/18 14/18 |
23.64±4.03 21.58±5.78 |
6/2 5/5 |
Y |
12 |
Kmax≥1 D/ 6mo, AST≥1
D/ 6mo,
SE≥0.5 D/ 6mo |
3 30 |
30 4 |
370 370 |
Ri 0.1% |
UV-X KXL®
system |
|
|
The Netherlands |
RCT |
SC AC AC AC |
36/36 36/36 33/33 33/33 |
22.8±5.0 23.1±4.7 19.9±5.8 24.2±7.1 |
NA NA NA NA |
N |
15.32±3.39 |
Kmax≥1-1.5
D/ 6mo, AST ≥1-1.5
D/6mo, thinnest CT↓ ≥5%/6mo |
3 9 18 30 |
30 10 5 3 |
365 365 365 365 |
Ri 0.1% in 20% dex |
Avedro KXL
system |
|
|
Japan |
PCS |
SC AC |
18/18 30/21 |
30.83±5.2 31.17±5.5 |
NA NA |
NA NA |
12 |
NA NA |
3 30 |
30 3 |
365 365 |
Ri 0.1% in 20% dex |
CCL-365
Vario KXL |
|
Region |
Study design |
Group |
Eye/ patient (n) |
Age (a) |
Gender (M/F) |
Baseline balance (Y/N) |
Follow-up (mo) |
Definition for progressive keratcous |
Intensity (mW/cm2) |
Duration (min) |
Wave legth (nm) |
Riboflavie |
Apparatus |
|
|
Turkey |
RCT |
SC TC |
7/7 6/6 |
22.71±10.14 24.50±68.11 |
3/4 4/2 |
Y |
6 |
Kmax≥1
D/y, SE≥0.5 D/2y, AST≥1.0 D/2y |
3 3 |
30 30 |
NA NA |
Ri 0.1% in
20% dex Ri
0.1%+dex 20%+THAM+EDTA |
Peschke
Meditrade, GmbH, |
|
|
Saudi
Arabia |
RCT |
SC TC |
36/36 34/34 |
24.1±5.3 24.8±4.2 |
15/21 16/18 |
Y |
36 |
Kmax≥1
D/y, AST≥1 D/y |
3 3 |
30 30 |
NA NA |
Ri 0.1% in
20% dex Ri + with
dex |
UV-X unit |
|
|
Turkey |
RCS |
SC TC |
30/20 30/23 |
23.7±3.9 22.8±4.7 |
NA NA |
Y |
18 |
Kmax≥1 D/ 6mo, AST ≥1 D/6mo |
3 3 |
30 30 |
365 365 |
Ri 0.1% in
20% dex Ri
0.1%+dex 20%+THAM+EDTA |
Ricrolin
TE |
|
|
Turkey |
PCS |
SC AC |
18/12 18/15 |
15.5±1.7 15.4±1.7 |
6/6 7/8 |
Y |
24 |
Kmax≥1 D/ 6mo, AST ≥1 D/6mo,
VA↓≥1 line |
3 3 |
30 30 |
365 365 |
Ri 0.1% in
20% dex 0.25% ri
1.2%+THAM+0.01% BZK |
Vega |
|
|
Turkey |
PCS |
SC TC |
19/19 17/17 |
27.16±2.4 27.35±5.95 |
9/10 8/9 |
Y |
12 |
Kmax≥1 D/ 6mo, AST ≥1 D/6mo |
3 3 |
30 30 |
366-374 366-374 |
Ri 0.1% in
20% dex Ri
0.1%+15% dex+EDTA+THAM |
CBM-X-Linker |
|
|
Italy |
RCS |
SC TC |
23/19 16/11 |
14.75±2.1 15±4.2 |
14/5 8/3 |
Y |
12 |
Kmax≥1 D/ 6mo, AST ≥1 D/6mo |
3 3 |
30 30 |
365 NA |
Ri 0.1% in
20% dex Ri
0.1%+15% dex+EDTA+THAM |
Vega CBM X
linker Vega |
|
|
India |
RCT |
SC TC |
20/20 20/20 |
23.95±4.08 22.35±3.95 |
17/3 15/5 |
Y |
6 |
Kmax≥1 D/y |
3 3 |
30 30 |
765 765 |
NA |
CL-UVR
machine |
|
|
Italy |
RCT |
SC TC |
10/10 10/10 |
30.4±7.3 28±3.8 |
5/5 6/6 |
Y |
12 |
UDVA,
CDVA↓≥1 line/6mo, Kmax≥1 D/ 6mo, AST ≥1 D/6mo |
3 3 |
30 30 |
370 NA |
Ri 0.1% in
20% dex Ri
0.1%+15% dex+EDTA+THAM |
UV-X
System NA |
|
|
The Netherlands |
RCT |
SC TC |
26/26 35/26 |
24 24 |
19/7 28/7 |
N |
12 |
Kmax,Kmean
and/or topographic cylinder ≥0.5
D/6-12mo |
3 3 |
30 30 |
365 365 |
Ri 0.1% in
20% dex Ri
0.1%+15% dex+EDTA+THAM |
UV-X |
|
|
Norway |
RCT |
SC TC |
10/20 10/20 |
29.5 |
17/3 |
NA NA |
12 |
AST or
myopia≥1 D/ 12mo, Sim
K≥1.5 D/12mo |
3 3 |
30 30 |
365 365 |
Ri 0.5%
without dextran |
UV-X lamp |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
12 |
13 |
14 |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
Y |
Y |
Y |
N |
N |
Y |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
Y |
U |
Y |
Y |
Y |
Y |
Y |
|
|
Y |
Y |
N |
Y |
Y |
Y |
Y |
Y |
U |
Y |
Y |
N |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
Y |
Y |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
N |
Y |
Y |
Y |
Y |
N |
U |
Y |
Y |
Y |
Y |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
N |
N |
Y |
|
|
Y |
Y |
U |
Y |
Y |
N |
Y |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
U |
Y |
Y |
Y |
Y |
N |
Y |
Y |
Y |
Y |
Y |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
N |
U |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
Y |
Y |
N |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
U |
U |
Y |
N |
N |
N |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
N |
Y |
Y |
N |
N |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
N |
Y |
N |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
N |
Y |
Y |
Y |
Y |
N |
U |
U |
Y |
Y |
N |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
N |
Y |
U |
Y |
Y |
N |
Y |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
N |
Y |
U |
Y |
Y |
N |
Y |
N |
Y |
|
|
Y |
Y |
Y |
Y |
Y |
Y |
Y |
U |
Y |
Y |
Y |
Y |
Y |
Y |
|
|
Y |
Y |
Y |
U |
Y |
Y |
N |
U |
U |
Y |
N |
Y |
N |
Y |
|
|
Y |
Y |
N |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
N |
Y |
Y |
Y |
Y |
U |
U |
Y |
Y |
Y |
Y |
Y |
|
|
Y |
Y |
U |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
|
Y |
Y |
U |
U |
Y |
Y |
N |
U |
U |
Y |
Y |
Y |
N |
Y |
|
Sample
size (Na, Ns, Nt) |
Mean
difference (95%CI) |
Heterogeneity
(I2) |
P |
Effect-model
(Ra/Fi) |
|
|
|
|||||
|
Na=247,
Ns=263 |
0.49
(0.04, 0.94) |
75% |
0.03a |
Ra |
|
|
Na=140,
Ns=139 |
0.01 (-0.06,
0.09) |
65% |
0.74 |
Ra |
|
|
Na=167,
Ns=168 |
-0.02
(-0.12, 0.07) |
93% |
0.63 |
Ra |
|
|
Na=105,
Ns=95 |
0.62
(0.38, 0.86) |
22% |
<0.00001a |
Fi |
|
|
Na=98,
Ns=91 |
-38.84
(-116.32, 38.64) |
96% |
0.33 |
Ra |
|
|
Na=91,
Ns=90 |
0.54
(-2.52, 3.06) |
6% |
0.73 |
Fi |
|
|
Na=196,
Ns=183 |
4.70 (-9.36,
18.7) |
1% |
0.51 |
Fi |
|
|
|
|||||
|
Nt=161,
Ns=161 |
1.15
(0.54, 1.75) |
50% |
0.0002a |
Ra |
|
|
Nt=126,
Ns=126 |
0.01
(-0.01, 0.03) |
34% |
0.57 |
Fi |
|
|
Nt=161,
Ns=161 |
-0.01
(-0.05, 0.02) |
46% |
0.47 |
Ra |
|
|
Nt=130,
Ns=12 |
-0.53
(-1.19, 0.13) |
67% |
0.11 |
Ra |
|
|
Nt=56,
Ns=51 |
-133.49
(-145.94, -121.04) |
33% |
<0.00001a |
Fi |
|
|
Nt=119,
Ns=120 |
0.36
(-5.14, 5.87) |
48% |
0.90 |
Ra |
|
|
Nt=67,
Ns=75 |
-5.19
(-36.15, 25.76) |
0 |
0.74 |
Fi |
|
60 Touboul D, Efron N, Smadja D,
Praud D, Malet F, Colin J. Corneal confocal microscopy following conventional,
transepithelial, and accelerated corneal collagen cross-linking procedures for
keratoconus. J Refract Surg
2012;28(11):769-776. [CrossRef] [PubMed]
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