Corneal cross-linking combined with UV-riboflavin is safe and effective in treating keratoconus, reveals the results of a two-year study in Cornea.

Dr Yakov Goldich et al., Department of Ophthalmology, Assaf Harofeh Medical Centre, Zerifin, Israel, included 14 eyes of 14 patients in the prospective, clinical-controlled study, with progressive keratoconus. Each patient was treated with CXL after corneal de-epithelization. Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), refraction, biomicroscopy and fundus examination, intraocular pressure, axial length, endothelial cell density, corneal topography, minimal corneal thickness, macular optical coherence tomography and corneal biomechanics were all recorded. Patients were assessed 1 week preoperatively and 1, 3, 6, 9, 12, and 24 postoperatively.

A significant improvement in BCVA was observed when the preoperative results were compared with the two-year postoperative results. UCVA was found to be stable and there was a strong reduction in steepest-meridian keratometry and mean cylinder.

There were no significant changes in mean simulated keratometry, minimal corneal thickness, endothelial cell density, corneal hysteresis and corneal resistance factor or foveal thickness. This suggests that the procedure is safe to conduct in the long term in treating progressive keratoconus.