Long-term study of topographic changes following pulsed accelerated corneal collagen cross-linking in progressive keratoconus

Purpose To evaluate long-term stability following pulsed accelerated cross-linking (CXL) in patients with progressive keratoconus by studying the changes in corneal topography. Patients and methods A retrospective study was conducted on patients with progressive grades 1–3 keratoconus who underwent epithelium-off pulsed-light accelerated corneal CXL (30 mW/cm 2 for 8 min) using the KXL system (Avedro Inc.). Follow-up period was 12–36 months. Topographic changes including maximum keratometry (K max ), minimum keratometry (K min ), topographic cylinder, central corneal thickness, and thinnest point (TP) were recorded and analyzed. Results A total of 72 eyes of 38 patients were included. The 12-month results showed significant reduction in K min ( P =0.038), central corneal thickness ( P <0.001), and TP ( P <0.001). At 24 and 36 months, there were no significant changes in corneal topography, except for reduction in TP ( P =0.024 and 0.002, respectively). Conclusion Pulsed accelerated CXL is an effective long-term method of arresting keratoconus progression.