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First Author: Z.Varga SWITZERLAND
Co Author(s): F. Hoogewoud T. Seiler F. Hafezi
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To evaluate the long-term refractive and topographic parameters of patients with the rare (1:200 CXL) and massive remodeling of the anterior corneal surface after corneal collagen cross-linking in an interventional case series.
All patinets were treated and followed up at the Institute of Refractive and Ocular Surgery, Zurich, Switzerland or at the University Hospitals of Geneva, Geneva, Switzerland.
Patients with progressive keratoconus had epi-off CXL performed following the standard protocol. Only patients with a massive remodeling of more than 6 diopter flattening within the first 12 postoperative months were included. Preoperative and postoperative BCVA, manifest refraction and Scheimpflug imaging of the cornea were recorded.
Significant changes were seen in BCVA, refractive cylinder, and anterior Kmax (average of 7.25D). Changes have been stable for over 24 months (range 6-38 months) On Scheimpflug imaging the posterior corneal elevation increased by 20 microns, the mean posterior K increased by 0.15D and the thinnest corneal thickness was reduced by 92 microns.
In cases with massive corneal remodeling following CXL, anterior corneal surface topography appears to be stable up to 3 years. Most interestingly, the anterior topographic changes do not appear to be mirrored by similar changes in the posterior corneal surface.