Abstract
BackgroundConventional corneal cross-linking is effective for retarding the progression of keratoconus. However the long-term efficacy and safety of accelerated (45 mW/cm2) transepithelial corneal cross-linking (ATE-CXL) on progressive keratoconus (KC) treatment is not fully understood. The purpose of this study is to evaluate the 2-year changes in corneal topographic parameters and densitometry values after ATE-CXL for KC.MethodsTwenty-five progressive eyes of 25 KC patients (KC group) and 25 eyes of 25 myopes without KC (control group) were enrolled. Corneal topography and densitometry values were evaluated pre-operatively and at 6, 12 and 24 months post-operatively in the KC group.ResultsThe mean values of flat keratometry (K1), steep keratometry (K2), mean keratometry (Km), corneal astigmatism (CA), maximum keratometry (Kmax), central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior corneal elevation (ACE) and posterior corneal elevation (PCE) all remained unchanged over time (all P values > 0.05). The densitometry values of the anterior, central, posterior and total layers over the annular diameters 0 mm to 2 mm (Φ0-2 mm) and Φ2–6 mm all decreased significantly (all P values < 0.05). At post-operative month 24, except for the densitometry value of the posterior layer (Φ0-2 mm), which was significantly lower than that of the control group (post hoc P = 0.010), all densitometry values obtained from the remaining locations of the KC eyes were equal to those of the control group (All post hoc P values > 0.05). Subgroups with Km ≥ 50.30D or ACE ≥35.3 μm progressed significantly when compared with those with Km < 50.30D (F = 8.167, P = 0.004) or ACE< 35.3 μm (F = 5.207, P = 0.022).ConclusionsK1, K2, Km, CA, Kmax, CCT, TCT, ACE, and PCE values may remain stable but severer KC patients tend to have poorer long-term outcomes. The densitometry values of the full corneal thickness (total layer over Φ0-2 mm and Φ2–6 mm) may decrease to normal levels at 2 years after ATE-CXL for KC.
Highlights
Keratoconus (KC) is a chronic ectatic corneal disease characterized by progressive corneal thinning and steeping which lead to irregular astigmatism and visual impairment [1]
Greenstein SA [11] reported a significant increase in corneal densitometry after conventional (3 mW/cm2) corneal crosslinking (C-CXL), and transient sub-epithelial haze is frequently detected after C-CXL [12, 13]
We investigated 2-year changes in corneal topographic parameters and densitometry values after Accelerated transepithelial corneal cross-linking (ATE-CXL) for KC
Summary
Keratoconus (KC) is a chronic ectatic corneal disease characterized by progressive corneal thinning and steeping which lead to irregular astigmatism and visual impairment [1]. One of our previous studies [15] investigated one-year outcomes of corneal topographic parameters and corneal densitometry after ATE-CXL for KC. The long-term effects of ATE-CXL on corneal densitometry and keratometry remain unknown. We investigated 2-year changes in corneal topographic parameters and densitometry values after ATE-CXL for KC. Conventional corneal cross-linking is effective for retarding the progression of keratoconus. The long-term efficacy and safety of accelerated (45 mW/cm2) transepithelial corneal cross-linking (ATE-CXL) on progressive keratoconus (KC) treatment is not fully understood. The purpose of this study is to evaluate the 2-year changes in corneal topographic parameters and densitometry values after ATE-CXL for KC
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