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Evaluating the efficacy of corneal cross-linking for correcting or preventing the progression of keratoconus

Poster Details

First Author: K.Kasai JAPAN

Co Author(s):    N. Kato   M. Shinzawa   Y. Okuyama   J. Shimazaki           

Abstract Details


To evaluate the efficacy of corneal cross-linking (CXL) in terms of its ability to both prevent the progression of and to treat keratoconus.


Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan.


This prospective study included 39 eyes of 35 patients (age: 20.5 ± 5.9 years) with progressive keratoconus who underwent CXL using riboflavin and ultraviolet-A irradiation (3.0 mW/cm2 for 30 min or 18.0 mW/cm2 for 5 min). Examinations were performed at pre-, 1, 3, 6, and 12 months after surgery, and annually thereafter. In addition to the usual ophthalmic examination, the steepest keratometric value (kmax), the thinnest corneal thickness (TCT) and the corneal endothelial cell density (ECD) were assessed each visit. The change of kmax (Δkmax) was calculated by subtracting preoperative from the postoperative kmax at 12 months.


The average change of kmax (Δkmax) was -2.01 ±3.50D (-11.60D to +2.70D). Five eyes showed a regression of more than 1.0D at the final visit; 3 were 14 years old, 1 was 17, and 1 was a 28 year old who had severe atopic dermatitis. Average kmax was 56.54D ±7.50D pre-operatively, and decreased to 53.99D +/- 5.95D (p<0.001) at 12 months. TCT and ECD did not change significantly. TheΔkmax was negatively correlated with the preoperative kmax (r² = -0.55, p<0.001) and age (r²=-0.39, p=0.013), and positively correlated with preoperative TCT (r²=0.29, p=0.068).


CXL halted the progression of keratoconus in 89.7% of the eyes. The greater the preoperative kmax and the thinner the preoperative TCT resulted in a larger flatteneing of the keratoconus using CXL. This indicates that CXL was effective not only to halt the progression of keratoconus but also to correct the corneal condition especially in advanced cases. Post-CXL, keratoconus cases in their early stages (younger patients) tended to continue to progress more than those in the later stages (older patients).

Financial Disclosure:

One or more of the authors gains financially from product or procedure presented

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