Longitudinal Influence Of Cross-Linking In Progressive Keratoconus On Keratometry And Vision - 10 Years Observation.
Published 2026 - 44th Congress of the ESCRS
Reference: PP16.10 | Type: Free paper | DOI: 10.82333/emf3-rc37
Authors: Mrs Karolina Deja* 1 , A/Prof. Justyna Izdebska 2 , Prof. Jacek Szaflik 2 , Prof. Jerzy Szaflik 3
1Laser Eye Microsurgery Centre,Warsaw,Poland;SPKSO Ophthalmic University Hospital,Warsaw,Poland, 2Laser Eye Microsurgery Centre,Warsaw,Poland;SPKSO Ophthalmic University Hospital,Warsaw,Poland;Department of Ophthalmology,Medical University of Warsaw,Warsaw,Poland, 3Laser Eye Microsurgery Centre,Warsaw,Poland;Department of Ophthalmology,Medical University of Warsaw,Warsaw,Poland
Purpose
To evaluate occurrence of hyperopic shift, keratometry and visual acuity changes in patients with progressive keratoconus (KC) treated with conventional collagen cross-linking (CXL) during 10 years observation.
Setting
Retrospective longitudinal study in Laser Eye Microsurgery Centre in Warsaw.
Methods
127 patients diagnosed with progressive keratoconus treated with CXL Dresden protocol before 2014 were evaluated. Best spectacle corrected visual acuity (BCVA), refraction from autorefractometer, spectacle correction, steep and flat simulated keratometry and thinnest corneal thickness (TCT) were assessed in 3 timepoints: preoperative, 1 year and 10 years- postoperatively.
Results
49 eyes of 36 patients met inclusion criteria. BCVA remained stable during observation (0,65±0,04 vs 0,68±0,04 vs 0,67±0,04). Spherical refraction presented myopic shift (-0,85±0,32 vs -1,04±0,33 vs -1,25±0,33; p=0,017), but spherical correction presented hyperopic shift (-3,21±0,49 vs -3,05±0,52 vs -2,16±0,53; p<0,001). Simulated steep and flat keratometry were stable at 1-year follow-up and decreased after 10 years (48,38±0,59 vs 48,4±0,57 vs 47,05±0,53; p<0,001 and 45,25±0,56 vs 45,34±0,55 vs 43,94±0,51; p<0,001). Thinnest corneal thickness decreased in every time point (480,7±5,33 vs 468,2±5,12 vs 433±7,71; p<0,001). Cylindrical refraction and correction and corneal astigmatism from keratometry did not change.
Conclusions
Conventional CXL performed for progressive KC stabilized vision and halted corneal steepening in 10 years observation. Corneal remodelling post CXL was a continuous process of corneal flattening and thinning. As a result of corneal thinning and stiffening, autorefractometer refraction shifted towards myopia. However, flattening of the cornea caused a shift towards hyperopia in effective spectacle correction. This observation shows that collagen cross-linking for progressive keratoconus causes dynamic remodeling of the corneal surface that may affect the vision even 10 years postoperatively.