Intraoperative and postoperative effects of corneal collagen cross-linking on progressive keratoconus

Objectives: To report intraoperative and 24-month refractive, topographic, tomographic, and aberrometric outcomes after corneal collagen cross-linking in progressive advanced keratoconus. Methods: Prospective, nonrandomized single-center clinical study involving 28 eyes. Main outcome measures included uncorrected and best spectacle-corrected visual acuities, sphere and cylinder refraction, topography, tomography, aberrometry, and endothelial cell count evaluated at baseline and follow-up at 1, 3, 6, 12, and 24 months after treatment. Topography was also recorded intraoperatively. Results: Two years after treatment, mean baseline uncorrected and best spectacle-corrected visual acuities improved significantly (P=.048 and 0 (piston), Z₂ (defocus), and Z₇ (III coma) decreased significantly (P≤.046). Mean 12-month baseline pupil center pachymetry and total corneal volume decreased significantly (P=.045). Endothelial cell counts did not change significantly (P=.13). Conclusions: Two years postoperatively, corneal collagen cross-linking appears to be effective in improving uncorrected and best spectacle-corrected visual acuities in eyes with progressive keratoconus by significantly reducing corneal average pupillary power, apical keratometry, and total corneal wavefront aberrations.