CORNEAL CROSS-LINKING IN PATIENTS AFFECTED BY KERATOCONUS: SAFETY AND EFFECTIVENESS

Haeder Benyaf H. Ali*

ABSTRACT

Objective: To conduct a thorough retrospective review of clinical outcomes and complications in order to assess the safety and effectiveness of corneal cross-linking (CXL) in patients with keratoconus (KCN). Methods: Retrospective analysis was performed on 1168 eyes from 886 individuals with diagnosed KCN who had CXL. Patients having at least a year of follow-up were included in the study, which was authorized by the ethics committee. Clinical and topographical markers were used to make the diagnosis, and ultraviolet A (UVA) and riboflavin were used for CXL. Following surgery, patients were observed at predetermined intervals, with an emphasis on safety results, corneal topography, and visual acuity. Results: The participants' average age was 22.48 ± 6.72 years, and the male-to-female ratio was 3.3:1. The cornea's thickness prior to surgery was 472.67 ± 38.21 µm. After three years, there was a substantial improvement in both uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (p = 0.03 and p = 0.007, respectively). The maximum keratometry, or Kmax, dropped (p < 0.001) from 56.28 ± 6.11 to 54.98 ± 6.18. Visual acuity and Kmax decrease showed stability across a five- and ten-year follow-up period. The depth of the demarcation line and corneal thickness stayed constant, with 99.2% of eyes exhibiting no advancement. Mild corneal haze, persistent corneal flattening in 1.97% of eyes, and peripheral sterile corneal infiltrates in 1.13% of instances were among the tolerable complications that had no appreciable effect on the final results. Conclusions: During long-term follow-up, CXL has shown to be a safe and effective treatment for progressive keratoconus, with notable improvements in corneal curvature and visual acuity. The technique is a good substitute for corneal transplantation since it has low risks and a high rate of stability in the progression of keratoconus.

Keywords: CXL, KCN, CDVA, UDVA.