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Anterior and posterior corneal outcomes after cross-linking for progressive keratoconus: visual, refractive, and Scheimpflug imaging analysis

Poster Details

First Author: G.Landim BRAZIL

Co Author(s):    A. Almeida   A. Bittencourt   A. Pereira   F. Machado   A. Shiguero        

Abstract Details


To evaluate corneal and visual changes after therapy for keratoconus with collagen crosslinking (CLX) using Scheimpflug analyzer.


Department of Refractive Surgery - Hospital Oftalmológico de Anápolis, Anápolis, Goiás, Brazil.


Prospective, nonrandomized study with 36 eyes of 23 patients with progressive keratoconus undergone CLX from 2015 to 2017. The eyes were saturated with riboflavin solution and subjected for 30 minutes to ultraviolet-A (UV-A) light with irradiance of 3 mW/cm². Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest refraction, corneal Scheimpflug imaging with Pentacam® (Oculus, Germany) analyzing maximum and central keratometry, difference between flattest and steepest meridian of anterior surface, posterior elevation and endothelial cell counts were performed at baseline and all postoperative follow-up examinations. Changes in visual, topographic, tomographic values were statistically analyzed.


Mean postoperative follow-up was 9.8 ± 5.1 months and mean patient age was 22.9 ± 5.1 years. The UDVA and CDVA improved significantly from 0.14 ± 0.11 to 0.20 ± 0,15 (P=0,040) and 0.38 ± 0.16 to 0.58 ± 0.19 (P=0,008), while maximum and central keratometry showed a significant decrease of 2.19(P=0.002) and 2.17(P=0,011) diopters (D), respectively. Although not reaching statistical significance, the mean baseline in flattest and steepest meridians decreased (-0.23D, P=0.401), and the maximum back elevation data increased (+7.81µm, P= 0,078). Endothelial cell count had no significant variations.


UDVA and CDVA improved significantly by CLX in eyes with progressive keratoconus allied with reduced anterior corneal values (maximum and central keratometry). Back corneal elevation increased, not reaching statistical significance. Corneal Scheimpflug imaging showed being useful in the follow-up for CLX once keratometry has suffered statistical significant changes.

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