Corneal Tomographic Changes After UV Cross-Linking for Corneal Ectasia (1-Year Results)

To evaluate changes in maximum keratometry (Kmax), corneal higher-order aberrations (HOAs), and densitometry (backscattered light) up to 1 year after UV cross-linking and their possible relation with changes in the visual outcome.

Retrospective cohort study on 18 eyes of 16 patients, who underwent UV cross-linking after the Dresden protocol for progressive keratoconus or ectasia after laser-assisted in situ keratomileusis. Corrected distance visual acuity (CDVA), Scheimpflug-based corneal tomography, mean image brightness (corneal densitometry) from the anterior 120 μm of the midcornea, and posterior 60 μm of the central 6 mm of the cornea, and HOAs were evaluated.

Kmax at 1 month (59.7 ± 6.0D) after UV cross-linking resembled preoperative Kmax (59.3 ± 6.4D, P = 0.368), decreased until 3 months postoperatively (58.3 ± 6.3D, P = 0.002), and stabilized thereafter (P > 0.227). All postoperative corneal densitometry values were higher than preoperative values in all measured depths (P < 0.05). One-month anterior and total corneal HOAs (4.28 ± 1.64 μm and 3.87 ± 1.62 μm, respectively) resembled preoperative values (4.10 ± 1.70 μm and 3.67 ± 1.62 μm, respectively; P > 0.221) and then decreased until 12 months postoperatively (3.86 ± 1.84 μm and 3.40 ± 1.80 μm, respectively; P < 0.005). Thinnest point thickness decreased from before (442 ± 25 μm) to 3 months postoperatively (427 ± 25 μm, P < 0.001), with no difference at 12 months postoperatively compared with preoperative values (437 ± 29 μm, P = 0.149). CDVA and endothelial cell density remained unchanged (P > 0.345 and P > 0.257, respectively). No relations were found between CDVA and the evaluated parameters (P > 0.05).

One year after UV cross-linking, the observation of stable CDVA and thinnest point thickness, together with reduced Kmax suggests no ectasia progression within the study period in these cases. Although HOAs showed a trend toward improvement, corneal densitometry remained elevated.