Standard and hypoosmolar corneal cross-linking in various pachymetry groups

Area of Science:

• Ophthalmology
• Corneal Surgery
• Biomaterials Science

Background:

• Keratoconus is a progressive thinning disorder of the cornea.
• Corneal cross-linking (CXL) is a standard treatment to halt keratoconus progression.
• The influence of corneal thickness on CXL outcomes requires further investigation.

Purpose of the Study:

• To evaluate the impact of central corneal thickness (CCT) on the efficacy and safety of CXL for progressive keratoconus.
• To compare outcomes between hypoosmolar and standard CXL based on preoperative CCT.

Main Methods:

• A cohort study involving 72 eyes with unilateral keratoconus treated with CXL.
• Eyes were grouped by CCT (Group 1: <400 μm, Group 2: 400-460 μm, Group 3: >460 μm) after riboflavin instillation.
• Outcomes including visual acuity, refraction, topography, pachymetry, and complications were assessed one year post-CXL.

Main Results:

• Corneal thickness decreased significantly in thinner corneas (<460 μm) and increased in thicker corneas (>460 μm) after riboflavin.
• Keratoconus progression was halted in over 86% of eyes across all groups.
• Visual acuity improved significantly in groups 1 and 3, with comparable safety and efficacy across all CCT groups.

Conclusions:

• Corneal thickness influences intraoperative CXL hydration dynamics but not 1-year outcomes.
• Both standard and hypoosmolar CXL demonstrate comparable safety and effectiveness in halting keratoconus progression.
• CXL is a reliable treatment option for progressive keratoconus across a range of corneal thicknesses.