Corneal changes in progressive keratoconus after cross-linking assessed by Scheimpflug camera

Area of Science:

• Ophthalmology
• Corneal Surgery
• Biomedical Engineering

Background:

• Progressive keratoconus leads to corneal thinning and irregular protrusion.
• Corneal cross-linking (CXL) is a treatment aimed at stiffening the cornea to halt progression.

Purpose of the Study:

• To assess corneal changes following CXL in patients with progressive keratoconus.
• To identify sensitive indicators of corneal remodeling post-CXL using Scheimpflug imaging.

Main Methods:

• Prospective study of 40 eyes (22 patients) with progressive keratoconus.
• Corneal CXL applied to 25 eyes; 15 fellow eyes served as controls.
• Evaluated visual acuity, corneal thickness, posterior elevation, and keratometry pre- and post-CXL using Pentacam.

Main Results:

• Significant improvements in manifest sphere, uncorrected, and corrected distance visual acuity in the CXL group.
• Corneal cross-linking led to significant reductions in corneal thickness, posterior elevation, and keratometry.
• Posterior elevation change was the most sensitive parameter for detecting corneal changes post-CXL (AUC=0.99).

Conclusions:

• Posterior elevation is a reliable parameter for monitoring corneal remodeling after CXL.
• Corneal CXL demonstrates a greater effect on reducing corneal protrusion in eyes with initially thinner corneas.