Transepithelial Accelerated Corneal Collagen Cross-Linking: Two-Year Results

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive corneal ectasia leading to vision impairment.
• Corneal collagen crosslinking (CXL) aims to strengthen the cornea and halt progression.
• Trans-epithelial accelerated corneal collagen crosslinking (TE-ACXL) offers a less invasive alternative.

Purpose of the Study:

• To evaluate the 2-year outcomes of the TE-ACXL procedure in patients with progressive keratoconus.
• To assess the safety and efficacy of TE-ACXL in halting keratoconus progression.

Main Methods:

• A retrospective interventional study included 24 eyes from 24 patients undergoing TE-ACXL.
• Outcome measures included best-corrected visual acuity (BCVA), keratometry, thinnest corneal thickness (PachyMin), and topometric indices.
• Data were analyzed preoperatively and at 6, 12, 18, and 24 months postoperatively.

Main Results:

• No intraoperative or postoperative complications were reported.
• No statistically significant changes were observed in BCVA, Kmax, astigmatism, PachyMin, or various topometric indices at 12 or 24 months.
• Disease progression occurred in 11-33% of patients by 24 months, based on defined progression criteria.

Conclusions:

• TE-ACXL appears to be a safe and effective treatment for keratoconus over a 2-year follow-up.
• Despite its overall efficacy, some patients may still experience disease progression.
• Further research with longer follow-up periods and larger patient cohorts is recommended.