Accelerated corneal collagen cross-linking for progressive keratoconus.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive eye condition characterized by thinning and bulging of the cornea.
• Standard corneal cross-linking (CXL) aims to strengthen the cornea and halt keratoconus progression.
• Accelerated CXL offers a potentially faster treatment protocol.

Purpose of the Study:

• To evaluate the efficacy of the accelerated corneal cross-linking (CXL) procedure in managing progressive keratoconus.
• To assess the impact of accelerated CXL on visual acuity, refractive error, and corneal topography.

Main Methods:

• Twenty-three eyes of 23 patients with progressive keratoconus underwent accelerated CXL.
• Preoperative and 6-month postoperative evaluations included visual acuity (UDVA, CDVA), refractive error (sphere, cylinder, SE), keratometry, thinnest corneal thickness (TCT), and endothelial cell density (ECD).
• Corneal topography was assessed using a Scheimpflug camera.

Main Results:

• Best corrected distant visual acuity (CDVA) significantly improved (p=0.026).
• Mean spherical equivalent (SE) showed a significant decrease (p=0.045), indicating refractive improvement.
• Topographic keratometric values (flat, steep, mean, and maximum) were significantly reduced (p<0.001 to p=0.03).
• Uncorrected distant visual acuity (UDVA), thinnest corneal thickness (TCT), and endothelial cell density (ECD) did not show statistically significant changes at 6 months.

Conclusions:

• Accelerated CXL is effective in stabilizing progressive keratoconus.
• The procedure leads to significant improvements in CDVA and reductions in topographic keratometric values within six months.
• Accelerated CXL demonstrates potential as a viable treatment for keratoconus management.