November 27, 2017
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Study shows CXL slows keratoconus progression

Corneal collagen cross-linking significantly and measurably slows the progression of keratoconus, according to a study conducted at the Chinese University of Hong Kong.

Forty-seven eyes of 38 patients with progressive keratoconus and a mean age of 27 years were included. Progression rate was measured before and more than 1 month after the corneal collagen cross-linking (CXL) treatment by steep, flat and average keratometry (K) and best-fit sphere (BFS) using linear mixed-effects models.

Accelerated epithelium-off corneal CXL was performed in all eyes.

After corneal CXL, a significant deceleration of the mean progression rate was observed. Anterior, posterior and average K decreased significantly. The preoperative negative anterior BFS progression rate turned positive after the treatment, representing a decrease in elevation profile, while the posterior BFS had a negligible rate of progression.

Greater reduction of the anterior average K after corneal CXL was reported in eyes with a higher baseline anterior average K.

“Our results suggest that baseline K could be a reliable predictor of the efficacy of CXL in halting the progression of keratoconus,” the authors wrote.

They also noted that CXL had a better effect on the anterior cornea than on its posterior surface, as shown by a reversal in the progression rate from steepening to flattening of the corneal curvature as well as a decrease in the elevation profile on the anterior surface.

Spherical equivalent and corneal thickness were not significantly altered by corneal CXL. Although CXL had a favorable effect, the difference did not reach statistical significance, they said. – by Michela Cimberle

Disclosure: The authors reported no conflict of interest.