Three-year clinical outcomes of accelerated epithelium-off corneal crosslinking for a case of superior keratoconus

Abstract

In this case report, we presented the long-term outcome of accelerated epithelium-off corneal crosslinking (CXL) for a case of superior keratoconus, which is a rare type of keratoconus. A 26-year-old man presented with progressive loss of vision in both eyes. The uncorrected distance visual acuity (UDVA) in the right eye was 0.1 in decimal corrected to 0.4 by a refraction of −1.00 diopter sphere (DS) −3.50 diopter cylinder (DC) @ 107, whereas the UDVA in the left eye was 0.01 corrected to 0.3 by a refraction of +2.00 DS −5.50 DC @ 31. Slitlamp examination of both eyes revealed a superior corneal protrusion without associated scarring or vascularization. Both eyes were diagnosed as grade 1 keratoconus with superior cone by Scheimpflug corneal tomography. Accelerated epithelium-off CXL was done for each eye separately in 2 consecutive sessions. The patient was followed up for 3 years with the improvement of the visual acuity as regards UDVA and corrected distance visual acuity and the improvement of the corneal topographic parameters, including keratometry, corneal elevation, and pachymetry. Accelerated epithelium-off CXL stabilized and halted the progression of superior keratoconus after long-term follow-up.