Delayed Topographical and Refractive Changes Following Corneal Cross-Linking for Keratoconus

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive corneal disease causing vision impairment.
• Corneal cross-linking (CXL) aims to halt keratoconus progression.
• Long-term outcomes of CXL on corneal topography and refraction require further analysis.

Purpose of the Study:

• To evaluate the long-term (≥5 years) topographic and refractive results of corneal cross-linking (CXL) in patients with keratoconus.

Main Methods:

• Retrospective observational study including 112 patients (150 eyes) with keratoconus treated with CXL.
• Data collected included corrected distance visual acuity (CDVA), refraction (sphere, cylinder), keratometry (average, maximum), and corneal aberrations.
• Minimum follow-up duration was 5 years.

Main Results:

• Significant improvements were observed in CDVA, spherical and cylindrical refraction, average and steepest keratometry, and corneal aberrations (p < 0.05), except for trefoil.
• Progressive improvements in refractive and keratometric indices, and corneal aberrations were noted over time.
• Greater improvement in corneal aberrations was associated with more severe baseline keratoconus.

Conclusions:

• Corneal cross-linking (CXL) provides sustained refractive and topographic benefits in keratoconus patients over the long term.
• Corneal aberrations show a consistent reduction post-CXL, particularly in advanced cases.
• CXL is an effective treatment for stabilizing and improving vision in keratoconus.