Abstract
Purpose
The study aims to investigate the effectiveness of corneal cross‐linking (CXL) treatment in keratoconus patients.
Methods
A total of 167 eyes of 159 progressive keratoconic patients (109 males and 58 females) aged 19 to 52 years old were included in the study. Epithelium debridement was performed for all patients, followed by riboflavin and UV‐A accelerated CXL (9.86 mW/cm2 for 9 min). To explore the effect of keratoconus severity on CXL outcomes, patients were divided into two groups based on the preoperative measurements of maximum keratometry (Kmax): Group A (Kmax < 62D) and Group B (Kmax ≥ 62 D). Corrected distance visual acuity (CDVA), corneal curvature and thickness were measured pre‐CXL and at 1, 2 and 3 years post‐CXL treatment using the Oculus Pentacam.
Results
Results showed a significant improvement in CDVA on logMAR chart (0.19 ± 0.41, p = 0.04) at 3 years follow‐up. Kmax reduced significantly by 1.61 ± 3.02D, p = 0.02 (from 64.35 ± 6.85D to 63.19 ± 6.99D) at 3 years after CXL. Pachymetry measurements showed a significant reduction at 1 year (p = 0.01), 2 years (p = 0.00005) and 3 years (p = 0.000002) following CXL. CXL induced a significant reduction in Kmax measurements in Group A at 3 years follow‐up (1.50 ± 2.17D, p = 0.02); however, there was no significant change observed at 3 years following CXL in Group B (p = 0.19). Kmax reduced or at least stabilised in all patients in Group A at 3 years follow‐up; however, 25% of eyes in Group B showed a Kmax worsening of ≥1D.
Conclusions
The findings of the current study show the effectiveness of CXL to stabilise the progression of keratoconus and significantly improve corneal curvature measurements. The progression of keratoconus is more likely to stabilise after CXL in eyes with lower Kmax measurements.