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Related Experiment Video

Updated: May 21, 2025

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Machine learning-based progress prediction in accelerated cross-linking for Keratoconus.

Qi Wan1, Qiong Wang1, Ran Wei1

  • 1Department of Ophthalmology, West China Hospital of Sichuan University, Sichuan Province, Chengdu City, China.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie
|March 18, 2025
PubMed
Summary
This summary is machine-generated.

Maximal keratometry (Kmax) and index of surface variance (ISV) predict keratoconus progression after accelerated corneal collagen cross-linking (A-CXL). A new nomogram using these factors improves personalized risk assessment for better treatment decisions.

Keywords:
A-CXLKeratoconusMachine-learningProgression

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Area of Science:

  • Ophthalmology
  • Corneal Disease Research
  • Medical Imaging and Biomechanics

Background:

  • Keratoconus is a progressive corneal ectasia requiring effective treatment.
  • Accelerated corneal collagen cross-linking (A-CXL) is a common therapeutic intervention.
  • Identifying prognostic factors for post-treatment progression is crucial for patient management.

Purpose of the Study:

  • To analyze corneal topographic and biomechanical parameters in keratoconus patients before A-CXL.
  • To identify prognostic factors for keratoconus progression post-A-CXL using machine learning.
  • To develop a predictive model for disease progression.

Main Methods:

  • Retrospective analysis of 95 eyes from 69 keratoconus patients undergoing A-CXL.
  • Corneal tomography (Pentacam) and biomechanical measurements (Corvis ST) at baseline and follow-up.
  • Application of LASSO, XGBoost, and random forest models; development of a nomogram.

Main Results:

  • 42.1% of eyes exhibited progression based on E-stage changes.
  • Higher maximal keratometry (Kmax) and index of surface variance (ISV) were associated with progression.
  • The developed nomogram demonstrated superior prediction accuracy for progression risk.

Conclusions:

  • Kmax and ISV are significant prognostic indicators for keratoconus progression after A-CXL.
  • The nomogram enhances prediction accuracy over individual parameters.
  • Personalized risk stratification aids in guiding clinical treatment decisions.