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Long-term effect of corneal collagen cross-linking on corneal innervation, corneal sensitivity and tear function of patients with keratoconus

Poster Details

First Author: G.Kontadakis GREECE

Co Author(s):    G. Kymionis   V. Kankariya   A. Pallikaris        

Abstract Details


To evaluate the long term effect of corneal collagen cross-linking (CXL) on corneal innervation, corneal sensitivity and tear function in patients with keratoconus.


Institute of Vision and Optics, University of Crete, Heraklion, Greece


Twenty four patients with bilateral keratoconus (30 eyes) underwent CXL. Quantitative analysis of corneal subbasal nerve plexus confocal microscopic images (total nerve length per image), corneal sensitivity (assessed with the Cochet–Bonnet esthesiometer), basic tear secretion (assessed with Schirmer’s I test with anesthesia) and tear film stability (evaluated by means of tear film break up time [TFBUT]) were assessed preoperatively and at 1, 3, 6, 9, 12, 18 and 24 postoperative month time intervals. Comparisons were made between preoperative and each postoperative value of total nerve length per image, corneal sensitivity, Schirmer’s I test results and TFBUT.


Total nerve length per image and corneal sensitivity were significantly decreased until the sixth postoperative month (for both parameters: p<0.05 paired samples t-test at 1, 3 and 6 postoperative month). Total nerve length per image tended to increase up to two years postoperatively, where it reached preoperative level, but differences with the preoperative values after the sixth post-CXL month were insignificant. Results of Schirmer’s I test and TFBUT had no statistically significant difference at any time point.


A transient decrease in corneal innervation and corneal sensitivity can be observed up to six months after CXL. No significant effect of CXL could be detected on basic tear secretion and tear film stability in our group of patients. Iatrogenic dry eye does not seem to be a major complication of CXL. FINANCIAL DISCLOSURE?: No

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