Accelerated (18 mW/cm 2 ) Corneal Cross-Linking for Progressive Keratoconus: 18-Month Results

PURPOSE: The aim of this study is to report the results of 18 months of follow-up after treatment with accelerated (18 mW/cm(2)) corneal cross-linking in patients with progressive keratoconus. METHODS: Forty-two eyes of 42 patients with progressive keratoconus were included in this retrospective study. All patients underwent accelerated corneal cross-linking at an irradiance of 18 mW/cm(2) for 5 min (total surface dose 5.4 J/cm(2)). Visual acuity, topographic findings (Kflat, Ksteep, Kaverage, and apical keratometry), and central corneal thickness were evaluated during the 18-month follow-up period. RESULTS: The mean ± standard deviation age of the 16 female and 26 male patients was 24.28 ± 6.32 years (range 14-36). Uncorrected distance visual acuity improved clinically significant from 0.52 ± 0.31 to 0.44 ± 0.25 logMAR (P = 0.031), and corrected distance visual acuity improved clinically significant from 0.34 ± 0.21 to 0.28 ± 0.19 logMAR (P = 0.018). At the last examination during the follow-up period, the flat keratometry (Kflat) decreased from a baseline of 45.65 ± 2.71 to 45.41 ± 2.72 diopters (D) (P = 0.001), the steep keratometry (Ksteep) decreased from 49.20 ± 3.54 to 48.96 ± 3.43 D (P = 0.023), and apical keratometry decreased from 56.62 ± 6.43 to 55.19 ± 5.69 D (P = 0.001), all of them were clinically significant at the 18-month visit. The preoperative values of central corneal thickness changed from 458.95 ± 38.79 to 461.85 ± 41.36 μm 18 months after the operation (P = 0.476). CONCLUSION: The accelerated corneal cross-linking was found to be effective for the stabilization of progressive keratoconus during the 18 months of follow-up visits.