Collagen Crosslinking For Progressive Keratoconus Research Articles

Late onset corneal haze after corneal collagen crosslinking for progressive keratoconus

Late onset corneal haze after corneal collagen crosslinking for progressive keratoconus

Time Course of Changes in Simulated Keratometry and Total Corneal Refractive Power after Corneal Collagen Cross-Linking for Progressive Keratoconus.

Purpose To assess the simulated keratometry (Sim K) and the total corneal refractive power (TCRP) in eyes undergoing conventional corneal cross-linking (CXL). Methods This study comprised 20 eyes of 20 keratoconic patients (14 men and 6 women; median age (25th and 75th percentile), 26.5 (21.8, 38.0) years) who underwent CXL. The Sim K and TCRP were measured with a rotating Scheimpflug system (Pentacam HR, Oculus), preoperatively and 1, 3, 6, and 12 months postoperatively. Results The values of Sim K were 52.65 (46.00, 55.70), 52.45 (45.85, 56.88), 51.70 (45.78, 55.83), 51.40 (45.68, 56.80), and 51.25 (46.08, 56.15) D preoperatively and 1, 3, 6, and 12 months postoperatively, respectively. The corresponding figures of TCRP were 52.10 (45.48, 55.08), 51.30 (45.18, 55.20), 50.95 (45.15, 54.50), 50.00 (45.18, 55.08), and 49.80 (45.48, 54.15) D, respectively. The variances of the Sim K and TCRP data were not statistically significant (p=0.994 and p=0.970, respectively, Kruskal–Wallis test). The Sim K was significantly larger than the TCRP before CXL and at 1, 3, 6, and 12 months after CXL (p<0.001, Wilcoxon signed-rank test). Conclusions Not only the Sim K but also TCRP was decreased by approximately 1 D after CXL. The Sim K readings may overestimate the TCRP, even after CXL for progressive keratoconus.

Corneal densitometry after accelerated corneal collagen cross-linking in progressive keratoconus.

To analyze changes in corneal densitometry 3months after accelerated corneal collagen cross-linking (CXL) measured with Scheimpflug tomography. In this study we reviewed charts and anterior segment data of patients who had undergone accelerated pulsed epithelium-off CXL (30 mW/cm2 for 4min, 8min total radiation time) for treatment of progressive keratoconus in the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Visual, topographic, pachymetric and densitometric data were extracted before surgery and at the 3-month follow-up. Corneal densitometry measurements from different corneal layers and zones obtained using Scheimpflug tomography (Pentacam HR, Oculus). The study investigated 12 eyes of 12 patients. The anterior (120μm) stromal layer within the 0.0 to 2.0mm and 2.0 to 6.0mm concentric zones showed a significant elevation of mean densitometry 3months post-surgery (P=0.045; P=0.015) compared to baseline. A mean stromal demarcation line was apparent at a depth of 203.00μm±13.53 (SD). After accelerated CXL, no change in mean corrected distance visual acuity (LogMAR) was observed but a thinning of the cornea measured by a significant reduction in central pachymetry (μm). Accelerated CXL results in an increase in corneal densitometry, particularly in the anterior stromal layer within the two central concentric zones (0.0 to 2.0mm and 2.0 to 6.0mm) of the cornea at 3months postoperatively. The changes in corneal densitometry of the anterior stromal layer did not correlate with postoperative visual acuity or central pachymetry.

Tear Function and Ocular Surface Alterations After Accelerated Corneal Collagen Cross-Linking in Progressive Keratoconus.

To investigate the alterations in the ocular surface and tear film parameters 3 months after accelerated corneal collagen cross-linking (A-CXL) in progressive keratoconus (KC) patients. Twenty-six patients (33 eyes total) with progressive KC were enrolled in this study. All patients were subjected to ophthalmic surface examination, such as OSDI (ocular surface disease index) scoring, the osmolarity tear test, Schirmer test, tear film breakup time (TBUT) analysis, rose bengal (RB) and fluorescein (Fl) ocular surface staining, and conjunctival impression cytology (IC) analysis, respectively. These tests were performed at baseline and 3 months after A-CXL. Nelson's grading system was used to evaluate the cell morphology and goblet cell density. No statistically significant differences in the levels of tear osmolarity, TBUT, Schirmer test, OSDI scoring, and Fl and RB staining between pretreatment and 3 months postoperatively were observed (all P values >0.05). A statistically significant increase in superior (P=0.005) and temporal (P=0.006) IC grading was seen at the postoperative third month compared to pretreatment. Only metaplastic changes and a reduction in the density of the goblet cells were seen in conjunctival IC, which is probably because of the toxicity of ultraviolet-A 3 months after A-CXL. However, these results do not lead to deterioration in TBUT. In this study, A-CXL has no adverse effect on ocular surface and tear function, which are important for visual quality.

Cost-Effectiveness Analysis of Corneal Collagen Crosslinking for Progressive Keratoconus

To evaluate the cost effectiveness of corneal collagen crosslinking (CXL) for progressive keratoconus from the healthcare payer's perspective. A probabilistic Markov-type model using data from published clinical trials and cohort studies. Two identical cohorts, each comprising 1000 virtual patients with progressive bilateral keratoconus, were modeled; one cohort underwent CXL and the other cohort received no intervention. Both cohorts were modeled and evaluated annually over a lifetime. Quality-adjusted life years (QALYs), total cost, disease progression, and the probability of corneal transplantation, graft failure, or both were calculated based on data from published trials and cohort studies. These outcomes were compared between the 2 cohorts. In our base scenario, the stabilizing effect of CXL was assumed to be 10 years; however, longer durations also were analyzed. One-way sensitivity analyses were performed to test the robustness of the outcomes. Incremental cost-effectiveness ratio (ICER), defined as euros per QALY. Assuming a 10-year effect of CXL, the ICER was €54 384/QALY ($59 822/QALY). When we adjusted the effect of CXL to a lifelong stabilizing effect, the ICER decreased to €10 149/QALY ($11 163/QALY). Other sensitivity and scenario analyses that had a relevant impact on ICER included the discount rate, visual acuity before CXL, and healthcare costs. Corneal collagen crosslinking for progressive keratoconus is cost effective at a willingness-to-pay threshold of 3 times the current gross domestic product (GDP) per capita. Moreover, a longer stabilizing effect of CXL increases cost effectiveness. If CXL had a stabilizing effect on keratoconus of 15 years or longer, then the ICER would be less than the 1× GDP per capita threshold and thus very cost effective.

RE: Tear Function and Ocular Surface Alterations After Accelerated Corneal Collagen Crosslinking in Progressive Keratoconus

RE: Tear Function and Ocular Surface Alterations After Accelerated Corneal Collagen Crosslinking in Progressive Keratoconus

Comment on 'Cost effectiveness of collagen crosslinking for progressive keratoconus in the UK NHS'.

Comment on ‘Cost effectiveness of collagen crosslinking for progressive keratoconus in the UK NHS’

Corneal collagen cross-linking for progressive keratoconus in patients aged 9 to 14

Purpose: To determine the safety and efficacy of corneal collagen cross-linking (CXL) for progressive keratoconus in patients aged between 9 and 14 years old. Methods: Sixteen eyes of 11 patients (8 male and 3 female) with progressive keratoconus underwent epithelium-off CXL according to the standard Dresden protocol. Mean follow-up was 26 months (range, 12 to 60 months). Pre- and postoperative examinations included: uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), corneal topography, tonometry, refraction, corneal pachymetry, and endothelium cell count. Results: At the last follow-up visit, BSCVA improved by at least one Snellen line in six eyes (37.5%) and remained stable in nine eyes (56.25%). Two eyes (12.5%) in habitual eye rubbers required a re-treatment due to keratoconus progression, at 15 and 28 months after first CXL. Manifest refraction and endothelium cell count remained stable. Topographic results showed statistically significant improvement in maximum K readings up to two years after CXL. However, this lost significance over time. No intraoperative complications were observed. Two eyes (12.5%) presented grade one haze, which regressed after a month of topical steroid therapy. Conclusion: In this study of selected patients aged 9 to 14, CXL was a safe and effective option for the treatment of progressive keratoconus. However, the effect in stemming the disease may not be long lasting and may require retreatment. A larger sample size and longer follow-up time are needed to verify this trend.

Accelerated (18 mW/cm²) Corneal Collagen Cross-Linking for Progressive Keratoconus.

The aim of this study was to determine the efficacy of accelerated riboflavin-ultraviolet A-induced corneal collagen cross-linking (CXL) (irradiance of 18 mW/cm² for 5 minutes). In this study, we retrospectively reviewed the charts and anterior segment data of patients after accelerated CXL. Visual, topographic, pachymetry, and densitometry data were extracted and analyzed before surgery and at follow-up (minimum 12 months) after treatment. A total of 28 eyes of 20 patients (mean age, 28.1 ± 8.1 years) were included in this study. The mean follow-up time was 21.7 ± 7.2 months (range, 12-34 months). No statistically significant changes were found in the mean corrected distance visual acuity, corneal astigmatism, Kmean, Kflat, Ksteep, corneal pachymetry (at the apex and at the thinnest point), and corneal densitometry at follow-up. A significant reduction of Kmax, index of surface variance, index of vertical asymmetry, and Km of the posterior corneal surface (Km(B)) was observed (Kmax: P = 0.018; index of surface variance: P = 0.016; index of vertical asymmetry: P = 0.038; Km(B): P = 0.008). No complications were reported during the postoperative follow-up period in this study. Based on a mean follow-up time of 21.7 months, accelerated CXL (18 mW/cm; 5 minutes) is effective in stopping the progression of keratoconus without raising any safety concerns. Improvement in Kmax and stabilization of corrected distance visual acuity were noted after treatment. However, prospective studies with longer follow-up using different accelerated CXL settings are needed to validate these findings.

Corneal Curvature Changes and Uncorrected Distance Visual Acuity after Corneal Collagen Cross-Linking for Progressive Keratoconus: A one year follow-up survey

Corneal Curvature Changes and Uncorrected Distance Visual Acuity after Corneal Collagen Cross-Linking for Progressive Keratoconus: A one year follow-up survey

One-year outcomes of conventional and accelerated collagen crosslinking in progressive keratoconus.

We compared one-year outcomes of conventional (3 mW/cm2, 365-nm ultraviolet-A light, 30 minutes) and accelerated (18 mW/cm2, 365-nm ultraviolet-A light, 5 minutes) collagen crosslinking (CXL) in patients with progressive keratoconus. Main outcome measures were change in keratometry, uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA). Nineteen patients in each group completed 1-year follow-up. Preoperatively, there were no inter-group differences for age, keratometry, corneal thickness, and spherical equivalent (p > 0.127). One year postoperatively, maximum and minimum keratometry were flattened by 1.6 diopters (p < 0.023) and 2 diopters (p < 0.047) respectively after conventional CXL, and, 0.47 diopters (p = 0.471) and 0.19 diopters (p = 0.120) respectively after accelerated CXL. Association analysis showed significant negative association between baseline maximum keratometry and change in maximum keratometry after accelerated CXL (p = 0.002) but not after conventional CXL (p = 0.110). Corneal thickness was reduced significantly in both groups (p = 0.017). An improvement in UCVA (p < 0.001) and BCVA (p < 0.022) was noted in both groups along with a reduction in spherical equivalent postoperatively (p < 0.026). There were no inter-group differences for any of the parameters postoperatively (p > 0.184). Although no statistically significant differences were observed between both treatment modalities, a more effective topographic flattening was observed with conventional CXL as compared to accelerated CXL in this study.

Cost effectiveness of collagen crosslinking for progressive keratoconus in the UK NHS.

Keratoconus is a progressive degenerative corneal disorder of children and young adults that is traditionally managed by refractive error correction, with corneal transplantation reserved for the most severe cases. UVA collagen crosslinking is a novel procedure that aims to prevent disease progression, currently being considered for use in the UK NHS. We assess whether it might be a cost-effective alternative to standard management for patients with progressive keratoconus. We constructed a Markov model in which we estimated disease progression from prospective follow-up studies, derived costs derived from the NHS National Tariff, and calculated utilities from linear regression models of visual acuity in the better-seeing eye. We performed deterministic and probabilistic sensitivity analyses to assess the impact of possible variations in the model parameters. Collagen crosslinking is cost effective compared with standard management at an incremental cost of £ 3174 per QALY in the base case. Deterministic sensitivity analysis shows that this could rise above £ 33,263 per QALY if the duration of treatment efficacy is limited to 5 years. Other model parameters are not decision significant. Collagen crosslinking is cost effective in 85% of simulations at a willingness-to-pay threshold of £ 30,000 per QALY. UVA collagen crosslinking is very likely to be cost effective, compared with standard management, for the treatment of progressive keratoconus. However, further research to explore its efficacy beyond 5 years is desirable.

Mechanical epithelial removal followed by corneal collagen crosslinking in progressive keratoconus: Short-term complications

To compare the complications occurring within the first 3 months of corneal collagen crosslinking (CXL) performed with mechanical or transepithelial phototherapeutic keratectomy (PTK) epithelial removal in keratoconus patients. Yildirim Beyazit University Ataturk Training and Research Hospital, Ankara, Turkey. Nonrandomized retrospective clinical study. Eyes of consecutive progressive keratoconus patients who had PTK or mechanical epithelial removal followed by CXL were included. All patients were examined regularly until epithelial healing. Detailed ophthalmologic examinations were performed preoperatively and 1 and 3 months postoperatively. The study comprised 499 eyes (302 patients) that had transepithelial PTK (Group 1, 153 eyes) or mechanical epithelial removal (Group 2, 256 eyes) followed by CXL. Delayed epithelial healing occurred in 15.0% of eyes in Group 1 and 3.5% of eyes in Group 2 (P = .001). Epithelial hypertrophy occurred in 24.8% of eyes and 3.5% of eyes, respectively (P = .001). Salzmann-like epithelial nodules (2.6%), epithelial herpetic keratitis (1.9%), anterior uveitis (1.9%), and elevated intraocular pressure (1.9%) occurred in Group 1 only and infective keratitis (0.8%) in Group 2 only. Marked stromal edema and peripheral sterile infiltrates occurred at similar rates in both groups (P = .567 and P = .479, respectively). Grade 1+ corneal haze was significantly high in Group 2. Grade 2+ and 3+ haze was significantly high in Group 1 (P = .001). Ocular surface healing disorders were the most common early complications of CXL. Short-term complications were higher with the transepithelial PTK epithelial removal technique than with mechanical epithelial removal. No author has a financial or proprietary interest in any material or method mentioned.

Corneal collagen crosslinking for progressive keratoconus in Saudi Arabia: One-year controlled clinical trial analysis

AimsTo determine the short-term efficacy of corneal collagen crosslinking (CXL) treatment in patients with progressive Keratoconus (KCN) in comparison with no treatment. Settings and designThis controlled clinical trial study was carried out at a tertiary eye hospital, Eastern Province, Saudi Arabia. Methods and materialA prospective controlled clinical study of patients being treated for Keratoconus at a tertiary eye care hospital in the Eastern province of Saudi Arabia. 51 eyes of 43 patients with progressive KCN who received corneal collagen crosslinking (treatment group) and 50 eyes of 34 patients with KCN and no treatment (control group) were included in our study. A one year clinical data were collected preoperatively as well as at 1, 3, 6 and 12months postoperatively for the treatment group patients. A baseline and 1year clinical data were collected for the control group patients. The short-term efficacy of the treatment in preventing progression of KCN in comparison with no treatment was analysed at one year. ResultsAt one year after crosslinking there was significant flattening of the average keratometry by 0.61D (p=0.001) [95% CI: 0.25, 0.97] compared to 0.40D (p=0.210) steepening in the control group; difference between treatment and control was 1.01D (p=0.006) [95%CI: 0.29, 1.72]. Pachymetry in treatment group thinned by 20.21μm (p<0.0001) [95% CI: 12.77, 27.66] compared to 0.32μm (p=0.912) in the control group. Visual acuity remained stable at the preoperative level of 20/30 (p=0.397) in the treatment group and 20/40 (p=0.553) in the control group at one year. ConclusionsCorneal CXL is an effective treatment for halting the progression of KCN as shown by reduced keratometry and stability of vision.

Long-term results of corneal collagen crosslinking for progressive keratoconus

PurposeTo evaluate long-term keratoconus stability after corneal crosslinking (CXL) with riboflavin. MethodsIn this prospective study, 57 eyes of 55 patients with progressive keratoconus, consecutively treated with ultraviolet A (UVA) – riboflavin CXL, were examined with the corneal topographer Pentacam, the biometer IOLMaster and the analyzer of corneal biomechanics Ocular Response Analyzer before and during a 24 months follow-up after CXL. ResultsTwenty-four months after CXL, there was a significant improvement in best corrected visual acuity (BCVA) (P<0.01), a significant decrease in corneal thinnest point (CTP), keratometry readings at the keratoconus apex (K max), and corneal volume (CV) (P<0.01), and a significant increase in axial eye length (AL) (P=0.01). No significant changes in anterior chamber volume (ACV) and depth (ACD), (P=0.8), corneal hysteresis (CH) (P=0.16) and corneal resistance factor (CRF) (P=0.06) were found. However, in the subgroup of patients with decreased K max readings 24 months after treatment, both CH and CRF showed a significant reduction (P<0.01). ConclusionIn the first month after the procedure, CXL induces a reduction in corneal volume. During the 24 months follow-up the cornea tends to recover its original volume with a persistence of the CXL efficacy.

A Randomized, Controlled Trial of Corneal Collagen Cross-Linking in Progressive Keratoconus

To report the refractive, topographic, and clinical outcomes 3 years after corneal collagen cross-linking (CXL) in eyes with progressive keratoconus. Prospective, randomized controlled trial. One hundred eyes with progressive keratoconus were randomized into the CXL treatment or control groups. Cross-linking was performed by instilling riboflavin 0.1% solution containing 20% dextran for 15 minutes before and during the 30 minutes of ultraviolet A irradiation (3 mW/cm(2)). Follow-up examinations were arranged at 3, 6, 12, 24, and 36 months. The primary outcome measure was the maximum simulated keratometry value (Kmax). Other outcome measures were uncorrected visual acuity (UCVA; measured in logarithm of the minimum angle of resolution [logMAR] units), best spectacle-corrected visual acuity (BSCVA; measured in logMAR units), sphere and cylinder on subjective refraction, spherical equivalent, minimum simulated keratometry value, corneal thickness at the thinnest point, endothelial cell density, and intraocular pressure. The results from 48 control and 46 treated eyes are reported. In control eyes, Kmax increased by a mean of 1.20±0.28 diopters (D), 1.70±0.36 D, and 1.75±0.38 D at 12, 24, and 36 months, respectively (all P <0.001). In treated eyes, Kmax flattened by-0.72±0.15 D,-0.96±0.16 D, and-1.03±0.19 D at 12, 24, and 36 months, respectively (all P <0.001). The mean change in UCVA in the control group was+0.10±0.04 logMAR (P= 0.034) at 36 months. In the treatment group, both UCVA (-0.15±0.06 logMAR; P= 0.009) and BSCVA (-0.09±0.03 logMAR; P= 0.006) improved at 36 months. There was a significant reduction in corneal thickness measured using computerized videokeratography in both groups at 36 months (control group:-17.01±3.63 μm, P <0.001; treatment group:-19.52±5.06 μm, P <0.001) that was not observed in the treatment group using the manual pachymeter (treatment group:+5.86±4.30 μm, P= 0.181). The manifest cylinder increased by 1.17±0.49 D (P= 0.020) in the control group at 36 months. There were 2 eyes with minor complications that did not affect the final visual acuity. At 36 months, there was a sustained improvement in Kmax, UCVA, and BSCVA after CXL, whereas eyes in the control group demonstrated further progression.

Outcome of corneal collagen crosslinking for progressive keratoconus in paediatric patients.

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients. Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min). Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P = 0.03) and 49.34 D (P = 0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P = 0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P = 0.51). Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

In Vivo Confocal Microscopy Analyses of Corneal Microstructural Changes in a Prospective Study of Collagen Cross-linking in Keratoconus

To use in vivo confocal microscopy (IVCM) to quantitatively analyze microstructural changes over time, after corneal collagen cross-linking for keratoconus. Prospective cohort study. A total of 38 eyes of 38 patients undergoing collagen cross-linking for keratoconus. Prospective, clinical cohort study of corneal collagen cross-linking in progressive keratoconus. Laser scanning IVCM performed preoperatively and at 1, 3, 6, and 12 months postoperatively. Density of corneal sub-basal nerves, anterior and posterior keratocytes, and corneal endothelium. Compared with baseline values, the mean sub-basal nerve density decreased significantly at 1, 3, and 6 months postoperatively (P < 0.01); however, this returned to preoperative values at 12 months (P = 0.57). One month postoperatively, there was complete absence of keratocyte nuclei in 86% of corneas. Anterior stromal edema with hyper-reflective cytoplasm and extracellular lacunae in a honeycomb-like appearance was observed and persisted at 3 months postoperatively. Scattered, presumed fragmented keratocyte nuclei, were observed at 1 and 3 months, but by 6 months, keratocyte repopulation of the anterior stroma was apparent. Quantitative analysis confirmed a significant decrease in the mean anterior keratocyte density 1, 3, and 6 months postoperatively (P ≤ 0.01) with return to baseline values at 12 months postoperatively (P = 0.57). The demarcation between treated and untreated corneal stroma appeared as a region where normal keratocytes transitioned into elongated, hyper-reflective, needle-like structures and then into large hyper-reflective stromal bands. There was no significant change in posterior keratocyte density or endothelial density at any postoperative time point. This prospective IVCM study revealed complete loss of the sub-basal nerve plexus and loss of anterior stromal keratocytes in the early postoperative period, with complete regeneration of the sub-basal nerve plexus and keratocyte repopulation by 12 months postoperatively. The posterior stroma and corneal endothelium were unaffected.

Safety Profile of High-Fluence Corneal Collagen Cross-Linking for Progressive Keratoconus: Preliminary Results From a Prospective Cohort Study

To investigate the effect of high-fluence corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A in the management of progressive keratoconus. Preliminary results from a prospective cohort study. Seven eyes from 7 patients with progressive keratoconus subjected to CXL were included. CXL was performed as a standard epithelium-off procedure, irradiating with high-fluence settings (18 mW/cm(2) for 5 minutes). Endothelial cell density (ECD), speed of postoperative epithelial healing, maximal and average keratometric readings (Kmax and Kmean, respectively) of the anterior corneal surface, and corrected distance visual acuity (CDVA) were evaluated preoperatively and at 1 and 6 months after CXL. One-way analysis of variance was applied for statistical analysis. P values less than .05 were considered significant. ECD did not change significantly postoperatively and complete epithelial healing occurred in all eyes within 96 hours postoperatively. No morphological alterations in the corneal limbus were observed. Kmax, Kmean, and CDVA showed no significant changes at 1 and 6 months postoperatively. No complications were observed postoperatively. Although the preliminary results are not sufficient for a valid evaluation of the biomechanical effect and the overall safety profile of high-fluence CXL in vivo, they demonstrate that CXL at 18 mW/cm(2) for 5 minutes affects neither endothelial cell density nor the speed of epithelial healing, an indirect indicator of limbal stem cell function.

Comparison of accelerated and conventional corneal collagen cross-linking for progressive keratoconus

Purpose: To compare outcomes of accelerated and conventional corneal cross-linking (CXL) for progressive keratoconus (KC).Materials and methods: Patients were divided into two groups as the accelerated CXL group and the conventional CXL group. The uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), refraction and keratometric values were measured preoperatively and postoperatively. The data of the two groups were compared statistically.Results: The mean UDVA and CDVA were better at the six month postoperative when compared with preoperative values in two groups. While change in UDVA and CDVA was statistically significant in the accelerated CXL group (p = 0.035 and p = 0.047, respectively), it did not reach statistical significance in the conventional CXL group (p = 0.184 and p = 0.113, respectively). The decrease in the mean corneal power (Km) and maximum keratometric value (Kmax) were statistically significant in both groups (p = 0.012 and 0.046, respectively in the accelerated CXL group, p = 0.012 and 0.041, respectively, in the conventional CXL group). There was no statistically significant difference in visual and refractive results between the two groups (p > 0.05).Conclusions: Refractive and visual results of the accelerated CXL method and the conventional CXL method for the treatment of KC in short time period were similar. The accelerated CXL method faster and provide high throughput of the patients.