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Updated: Jun 14, 2026
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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
[Corneal scar development after cross-linking in keratoconus].
Summary
Corneal collagen cross-linking (CXL) can cause scarring in some patients. Higher K-values and thinner corneas before CXL increase the risk of developing corneal scars, especially in advanced keratoconus.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Biomaterials Science
Background:
- Corneal collagen cross-linking (CXL) using riboflavin and UVA is a standard treatment for keratoconus.
- Understanding the factors influencing corneal scar development post-CXL is crucial for patient outcomes.
Purpose of the Study:
- To retrospectively evaluate corneal scar development after riboflavin-UVA-induced CXL.
- To identify predictive factors for corneal scarring following CXL.
Main Methods:
- Retrospective analysis of 163 CXL-treated eyes in 127 patients with stage 1-3 keratoconus.
- One-year follow-up recording uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), biomicroscopy, corneal topography (K-values), and corneal thickness.
Main Results:
- 91.4% of eyes (149) had clear corneas at 1 year; 8.6% (14) developed significant corneal scars.
- Preoperative mean K-values (71.1 D vs 62.1 D) and corneal thickness (420 μm vs 478.1 μm) were significantly higher and lower, respectively, in the scar group.
- Visual acuity improved in the clear cornea group but worsened in the scar group post-CXL.
Conclusions:
- Preoperative K-values and corneal thickness are significant predictive factors for corneal scarring after CXL.
- Advanced keratoconus, characterized by greater curvature and thinner corneas, is associated with an increased risk of scar formation post-CXL.
