Central Corneal Thickness Recovery Kinetics After Corneal Collagen Cross-Linking: Implications For Stromal Remodeling
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR163 | Type: Free paper | DOI: 10.82333/ym3r-8565
Authors: Dr Bunyamin Can 1 , Dr Fatma Sumer* 1
1Ophthalmology,Recep Tayyip Erdogan University,Rize,Türkiye
Purpose
To characterize the kinetics of central corneal thickness (CCT) recovery following standard corneal collagen cross-linking (CXL) in keratoconus and to identify factors influencing the recovery trajectory, providing insights into post-CXL stromal remodeling.
Setting
Department of Ophthalmology, Recep Tayyip Erdogan University Training and Research Hospital, Rize, Turkey. Prospective observational study.
Methods
Sixty keratoconus eyes undergoing epithelium-off CXL were evaluated with serial pachymetry (ultrasound and Scheimpflug) and specular microscopy (Tomey EM-4000) preoperatively and at 1, 3, and 6 months. CCT recovery rate and curve (polynomial regression) were generated. Correlations with preoperative CCT, age, Kmax, ECD, and keratoconus stage were analyzed. Sixty healthy controls provided baseline reference. Statistics: repeated measures ANOVA, Pearson correlation, multiple linear regression (SPSS 23.0; p<0.05).
Results
Ameliyat öncesi ortalama kornea kalınlığı (CCT) 476±29 µm idi. 1 ay sonra CCT %4,8 azaldı (453±31 µm; p<0,001), 3 ay sonra %58,7'ye ve 6 ay sonra %82,6'ya (472±27 µm; p=0,108, başlangıç değerine göre) yükseldi. İyileşme logaritmik bir eğri izledi (R²=0,91). Ameliyat öncesi CCT, 1 ay sonraki mutlak kaybı öngördü (r=0,42; p=0,001); yaş, iyileşme oranıyla ters orantılıydı (r=-0,31; p=0,016). ECD ve CCT değişiklikleri pozitif korelasyon gösterdi (r=0,38; p=0,003), bu da endotel-stromal stresin birlikte olduğunu düşündürmektedir. Keratokonus evresi, başlangıç CCT'sine göre ayarlandıktan sonra bağımsız bir öngörücü değildi. Ameliyat öncesi kornea kalınlığının %15'inden fazlasını kaybeden göz bulunmamıştır.
Conclusions
Post-CXL corneal thinning follows a predictable logarithmic recovery pattern with approximately 83% thickness restoration by 6 months. Thinner baseline corneas experience greater proportional thinning but follow similar recovery kinetics. The coupled endothelial-stromal response at 1 month suggests shared UV-A induced stress pathways. These findings inform patient counseling regarding temporary corneal changes and support considering delayed contact lens fitting or refractive assessment until full recovery.