Corneal collagen cross-linking halts progression of keratoconus

Br J Ophthalmol. 2011;95:1519-1524.

Researchers have found that corneal collagen cross-linking appears to be an effective and safe method of stopping the progression of keratoconus in patients with early or moderate bilateral keratoconus.

Results of this masked, randomized, prospective, bilateral study also showed improvements in visual and topographic parameters.

Twenty four patients with early or moderate bilateral keratoconus who recently experienced progression were recruited to the study. The goal was to investigate the efficacy of riboflavin/ultraviolet A corneal collagen cross-linking to halt the keratoconus progression.

Researchers randomly assigned one eye from each patient to undergo collagen cross-linking after epithelial removal using riboflavin 0.1% and ultraviolet A; the other eye was left untreated.

At follow-up 18 months later, the researchers saw significant reductions from baseline in treated compared with untreated eyes (P=0.04). In those eyes that were treated, best spectacle-corrected acuity improved (P=0.01). A decrease from baseline occurred in Orbscan II-simulated keratometry (P<0.001), 3 mm keratometry (P=0.008), simulated astigmatism (P=0.007), cone apex power (P=0.002), root mean square, coma, spherical aberration, secondary astigmatism and pentafoil (P=0.05), according to the study.

As for treatment effects, only one eye that was treated had transient recurrent corneal erosions. No other complications were attributable to treatment with corneal collagen cross-linking.