Preoperative Corneal Parameters As Predictors Of Corneal Collagen Cross-Linking Outcomes In Keratoconus

Published 2025 - 43rd Congress of the ESCRS

Reference: PO913 | Type: Poster

Authors: Pavel Beliakouski* ¹ , Mikalai Pazniak ¹ , Aleh Pazniak ¹ , Dmitriy Abelskyi ¹ , Elena Likhorad ¹ , Eugene Statsenko ² , Tahra A. Al Mahmoud ²

¹ophthalmology,Eye Microsurgery Center “Voka”,Minsk,Belarus, ²Radiology Department,College of Medicine and Health Sciences, United Arab Emirates University, Al Ain,Abu Dhabi,United Arab Emirates

Purpose

To identify key preoperative corneal parameters that predict the efficacy of corneal collagen cross-linking (CXL) in keratoconus patients and to develop predictive models that assist in optimizing patient selection and long-term management.

Setting

A retrospective study conducted at a specialized ophthalmology center, analyzing clinical data from keratoconus patients who underwent corneal collagen cross-linking (CXL) between January 2018 and December 2022.

Methods

A retrospective analysis was conducted on 107 patients (112 eyes) who underwent CXL between January 2018 and December 2022 at a specialized ophthalmology center. Patients with a history of repeated CXL or corneal pathologies unrelated to KC were excluded. The study cohort included 79 men and 28 women, with follow-up durations ranging from 4 to 40 months. A total of 796 clinical evaluations were analyzed, encompassing pachymetry, refractive assessments, and corneal topography. Predictive modeling was performed based on maximal keratometry (Kmax) and anterior corneal curvature parameters (K1 and K2).

Results

Postoperative analysis revealed a sustained reduction in corneal curvature metrics over a two-year period, followed by a four-month stabilization phase. Thereafter, a gradual increase in curvature values was observed. The predictive accuracy of the developed models, as assessed by mean absolute error (MAE), was 1.93±0.27% for K1, 4.01±0.24% for K2, and 2.66±0.31% for Kmax.

Conclusions

Preoperative corneal parameters are key predictors of CXL outcomes in keratoconus. Our findings indicate that while CXL initially reduces corneal curvature over two years, a stabilization phase is followed by a gradual increase. Notably, pronounced corneal thinning, low best-corrected visual acuity (BCVA), and high baseline Kmax are associated with less favorable long-term results. These factors should be carefully considered when selecting candidates for treatment. Given the variability in response, long-term monitoring is essential, and further research should focus on optimizing patient selection and enhancing CXL durability.