Topographical and Refractive Outcomes After Corneal Cross-linking in Novice Scleral Lens Users

To determine if scleral fittings that occur before corneal cross-linking (CXL) are still successful after the procedure.

This prospective study included seven patients with keratoconus or post-laser-assisted in situ keratomileusis (LASIK) corneal ectasia who were fitted with scleral lenses then underwent CXL. Four patients (six eyes) had keratoconus and three patients (five eyes) had post-LASIK ectasia. Topographic and refractive parameters, as well as uncorrected visual acuity, best spectacle-corrected visual acuity, and scleral lens-corrected visual acuity were collected preoperatively and compared with values 1 and 3 months postoperatively.

Ten eyes had no significant change in refractive parameters from baseline to 3 months ( P >0.05). Nine eyes had no significant change in Km (mean keratometry), K2 (steep keratometry), Kmax (maximal corneal curvature), or pachymetry from baseline to 3 months ( P >0.05). On average, there was no significant difference regarding scleral lens or topographic measurements preoperatively versus postoperatively ( P >0.05).

On average, no significant differences were observed between preoperative and postoperative corneal measurements or refractive correction. These findings suggest that scleral fittings could be introduced before CXL to expedite the process of lens prescription and future acquisition. Safe scleral lens use with a lens fit before surgery could resume 1 month postoperatively.