Long-term Outcomes of Collagen Crosslinking for Early Keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive corneal ectasia leading to vision impairment.
• Early intervention is crucial to halt disease progression and preserve visual function.
• Collagen crosslinking (CXL) aims to strengthen the cornea and prevent further steepening.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of corneal collagen crosslinking (CXL) for treating early-stage keratoconus.
• To assess changes in visual acuity, refractive error, and corneal structure over a nine-year period post-CXL.

Main Methods:

• A prospective study involving thirty eyes of twenty patients diagnosed with early keratoconus.
• Comprehensive ophthalmologic examinations including visual acuity, refraction, corneal topography, and pachymetry were performed preoperatively and at multiple follow-up intervals up to nine years.
• Surgical procedure involved standard corneal collagen crosslinking protocol.

Main Results:

• Long-term follow-up (9 years) showed stable uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA).
• A significant improvement in mean objective spherical equivalent was observed, while subjective spherical equivalent remained stable.
• Mean central corneal thickness (CCT) and corneal curvature measurements remained stable, indicating no significant disease progression.
• No significant postoperative complications were reported, highlighting the safety of the procedure.

Conclusions:

• Corneal collagen crosslinking is a safe and effective long-term treatment for early keratoconus.
• CXL successfully stabilizes visual acuity and corneal thickness in patients with early keratoconus.
• The procedure demonstrates potential for refractive improvement, specifically in objective spherical equivalent.