Evaluation of Corneal Aberration Alterations After Accelerated Transepithelial Corneal Crosslinking

Abstract

Objective: This study aimed to report the corneal aberration alterations after accelerated transepithelial corneal crosslinking (A-TE CXL) and to investigate the relationship between corrected distance visual acuity (CDVA) and corneal aberrations.
 Methods: Fifty-six eyes of 45 progressive keratoconus (KCN) patients who underwent A-TE CXL were retrospectively evaluated. Total ocular aberrations (TOA), high-order aberrations (HOA), low order aberrations (LOA), and spectacle-CDVA values were recorded preoperatively, 6, and 12 months after the procedure. The alterations of the parameters were compared and correlation analysis was performed between corneal aberrations and CDVA.
 Results: The mean age of the patients was 22.23±3.14 years. The preoperative, postoperative 6 and 12 months median CDVAs were 0.50 (0.20-0.90), 0.60 (0.20-1.0) and 0.60 (0.10-0.90), respectively. The preoperative root means square (RMS)-TOA, RMS-HOA, and RMS-LOA values were 2.4±0.88μm, 1.50±0.59μm, and 1.78±0.88μm, respectively. The CDVA values increased significantly at postoperative-6 month examinations. After the A-TE CXL procedure, the aberrations were detected as 2.58±0.94μm, 1.62±0.57μm, 1.90±0.99μm and 2.38±0.81μm, 1.46±0.57μm, 1.77±0.85μm at 6th and 12th months, respectively. The TOA and HOA values significantly decreased 6 and 12 months after A-TE CXL. The LOA alterations were not statistically significant. The correlation analysis between corneal aberrations and CDVA revealed no significance at any time point.
 Conclusion: Although the TOA and HOA values significantly decreased and CDVA significantly increased in the early postoperative period, a relationship between the CDVA and corneal aberration alterations was not detected. Even the corneal aberration improvement had contributed to the increase in CDVA, evaluation of epithelial structural alterations can be suggested to better understand the clinical outcomes.