Accelerated corneal collagen cross-linking for progressive keratoconus

To evaluate the efficacy of accelerated corneal cross-linking (CXL) procedure for progressive keratoconus.

Twenty-three eyes of 23 patients undergone accelerated CXL procedure were evaluated preoperatively and postoperatively at 1st, 3rd and 6th month for uncorrected distant visual acuity (UDVA), best corrected distant visual acuity (CDVA), spherical error, cylindrical error, spherical equivalent (SE), keratometric values and thinnest corneal thickness (TCT) values with corneal topography by Scheimpflug camera and endothelial cell density (ECD).

The mean UDVA was improved from 0.97 ± 0.41 logarithm of minimal angle of resolution (logMAR) to 0.76 ± 0.45 logMAR at the 6th month after CXL (p = 0.332). The mean CDVA was improved from 0.49 ± 0.30 logMAR to 0.34 ± 0.22 logMAR at the 6th month after CXL (p = 0.026). The mean sphere was decreased from -4.47 ± 4.1 diopter (D) to -3.79 ± 3.86 D and the mean cylinder was decreased from -5.60 ± 2.2 D to -4.55 ± 1.98 D and the mean SE was decreased from -7.22 ± 4.48 D to -6.36 ± 4.34 D at the 6th month after CXL (p = 0.128, p = 0.002 and p = 0.045, respectively). Flat keratometry, steep keratometry, mean keratometry and maximum keratometry were significantly reduced at the 6th month after CXL (p = 0.025, p < 0.001, p = 0.004 and p = 0.03, respectively). TCT and ECD were not changed significantly the 6th month after CXL (p = 0.135 and p = 0.082, respectively).

Accelerated CXL procedure was effective to stabilize progression of keratoconus with significant reduction in topographic keratometric values and significant increase in CDVA in 6 months.