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Related Experiment Video

Updated: Jan 28, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
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Intraocular Pressure Changes Following Corneal Cross-Linking in Patients With Keratoconus.

Wufan Zhao1, Jamie Karl, Elizabeth Fan

  • 1Department of Ophthalmology, Duke University School of Medicine, Durham, NC.

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|January 27, 2026
PubMed
Summary

Corneal collagen cross-linking (CXL) temporarily increases intraocular pressure (IOP) in keratoconus patients, returning to normal by 4.5 months. IOP measurement methods affect results, highlighting the need for careful monitoring post-CXL.

Keywords:
cross-linkingintraocular pressurekeratoconus

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Glaucoma Research

Background:

  • Keratoconus management often involves corneal collagen cross-linking (CXL).
  • Intraocular pressure (IOP) monitoring is crucial, especially in patients with glaucoma risk factors.
  • Understanding IOP fluctuations post-CXL is essential for patient management.

Purpose of the Study:

  • To assess IOP changes after CXL in keratoconus patients.
  • To compare IOP measurements obtained from different tonometry devices.
  • To identify the temporal pattern of IOP changes following CXL.

Main Methods:

  • Retrospective chart review of 405 keratoconus patients undergoing CXL.
  • IOP measurements collected preoperatively and at 1, 3, and ≥4.5 months postoperatively.
  • Analysis included tonometry method (iCare, Tonopen, Goldmann), corticosteroid use, and patient demographics.

Main Results:

  • Treated eyes showed significant IOP increase at 1 and 3 months post-CXL, normalizing by ≥4.5 months.
  • Untreated fellow eyes had no significant IOP changes.
  • Tonopen measurements were consistently higher than iCare; both showed transient elevations post-CXL.

Conclusions:

  • CXL is associated with transient postoperative IOP elevations in keratoconus patients.
  • IOP normalizes by approximately 4.5 months after CXL.
  • Tonometry method impacts IOP readings; awareness is key for glaucoma risk management post-CXL.