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Objective <p>To evaluate the refractive, keratometric, and biomechanical changes in keratoconus patients following modified accelerated corneal cross-linking (A-CXL).</p> Methods <p>This retrospective observational study analyzed clinical data from patients with progressive keratoconus who underwent modified A-CXL with a prolonged riboflavin imbibition period prior to UV irradiation. Preoperative and post-operative data on vision, refraction, tomography using OCULUS Pentacam and biomechanics using Corvis ST were analyzed at various follow-up intervals. Subgroup analysis was conducted based on topographic keratoconus classification. Statistical comparison was performed to assess changes in these parameters over time.</p> Results <p>A total of 70 eyes of 55 patients were included. A statistically significant improvement in mean change of logMAR BCVA was noted at 6 and 12&#xa0;months (<i>p</i> = 0.006 and <i>p</i> = 0.018). Six months following A-CXL, statistically significant improvements were observed in keratometry and pachymetry (<i>p</i> = 0.003 and <i>p</i> &lt; 0.001). Mean changes in biomechanical parameters deformation amplitude ratio (DAR) and Integrated Radius (IR) were found to be significantly decreased at 6&#xa0;months (<i>p</i> = 0.001 and <i>p</i> = 0.011). Other biomechanical parameters SPA1, SSI and ARTh had no significant changes suggesting stability. Comparative analysis between different stages of keratoconus revealed that patients classified under TKC-4 exhibited greater improvement in keratometry compared to those with TKC-2 and TKC-3 staging.</p> Conclusion <p>A-CXL with extended riboflavin exposure was effective in stabilizing both tomographic and biomechanical parameters which resulted in increased corneal stiffness and maintained stability. All KC stages demonstrated corneal stability following A-CXL.</p>

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Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study

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  • 发表日期：

    2025年7月1日

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  • Robert Edward T. Ang,
  • Alvin Joseph A. Guloy Jr,
  • Emerson M. Cruz,
  • Jimmy Jarvis Gene C. Lo

摘要

Objective

To evaluate the refractive, keratometric, and biomechanical changes in keratoconus patients following modified accelerated corneal cross-linking (A-CXL).

Methods

This retrospective observational study analyzed clinical data from patients with progressive keratoconus who underwent modified A-CXL with a prolonged riboflavin imbibition period prior to UV irradiation. Preoperative and post-operative data on vision, refraction, tomography using OCULUS Pentacam and biomechanics using Corvis ST were analyzed at various follow-up intervals. Subgroup analysis was conducted based on topographic keratoconus classification. Statistical comparison was performed to assess changes in these parameters over time.

Results

A total of 70 eyes of 55 patients were included. A statistically significant improvement in mean change of logMAR BCVA was noted at 6 and 12 months (p = 0.006 and p = 0.018). Six months following A-CXL, statistically significant improvements were observed in keratometry and pachymetry (p = 0.003 and p < 0.001). Mean changes in biomechanical parameters deformation amplitude ratio (DAR) and Integrated Radius (IR) were found to be significantly decreased at 6 months (p = 0.001 and p = 0.011). Other biomechanical parameters SPA1, SSI and ARTh had no significant changes suggesting stability. Comparative analysis between different stages of keratoconus revealed that patients classified under TKC-4 exhibited greater improvement in keratometry compared to those with TKC-2 and TKC-3 staging.

Conclusion

A-CXL with extended riboflavin exposure was effective in stabilizing both tomographic and biomechanical parameters which resulted in increased corneal stiffness and maintained stability. All KC stages demonstrated corneal stability following A-CXL.