Crosslinking Improved Visual Acuity in Keratoconic,Ectatic Eyes

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Corneal collagen crosslinking (CXL) improved distance UCVA, distance BCVA, and maximum and average keratometry values in patients with keratoconus and corneal ectasia, according to a study in the Journal of Cataract & Refractive Surgery.¹

Researchers at the Cornea and Laser Eye Institute in Teaneck, New Jersey, conducted a prospective, controlled study to evaluate the 1-year outcomes of CXL for the treatment of keratoconus and ectasia. Participants were randomized to receive standard ultraviolet-A plus riboflavin 0.1% CXL treatment (n=77 eyes; 49 keratoconus, 22 ectasia) or riboflavin 0.1% ophthalmic solution alone (n=41 eyes; 28 keratoconus, 13 ectasia). The investigators obtained distance UCVA, BCVA, and topographic measurements for all participants preoperatively and at 1, 3, 6, and 12 months postoperatively.

In the treatment group, distance UCVA improved from 0.84 ±0.34 logMAR to 0.77 ±0.37 logMAR, and distance BCVA improved from 0.35 ±0.24 logMAR to 0.23 ±0.21 logMAR. Fifteen patients (21.1%) gained 2 or more lines of distance BCVA, and one patient (1.4%) lost 2 or more lines of distance BCVA. Maximum keratometry decreased from baseline by 1.70 ±3.90 D, 2.00 ±4.40 D, and 1.00 ±2.50 D in the entire cohort, the keratoconus subgroup, and the ectasia subgroup, respectively. The maximum keratometry values decreased by 2.00 D or more in 22 CXL-treated patients (31.0%) and increased by 2.00 D or more in three CXL-treated patients (4.2%).

“Keratoconus patients had more improvement in topographic measurements than patients with ectasia,” the study authors concluded. “Both [distance BCVA] and maximum [keratometry] value worsened between baseline and 1 month, followed by improvement between 1, 3, and 6 months and stabilization thereafter.”

1. Hersh PS,Greenstein SA,Fry KL.Corneal collagen crosslinking for keratoconus and corneal ectasia:one-year results.J Cataract Refract Surg.2011;37(1):149-160.

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