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The effect of transepithelial corneal collagen cross-linking treatment on optical quality of the cornea in keratoconus: 12-month clinical results

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Abstract

Purpose

To evaluate the effect of transepithelial corneal collagen crosslinking (CXL) treatment on the optical performance of the cornea at 12-month follow-up after CXL in patients with progressive keratoconus.

Methods

One hundred and ten eyes of 67 patients were included. The following corneal optical aberrations over the 4-mm-diameter pupil were recorded via Sirius dual-scanning corneal tomography: total, anterior and posterior amount of corneal higher order aberrations [HOAs], vertical coma, horizontal coma, vertical trefoil, oblique trefoil, and spherical aberration, and Strehl ratio of point spread function (PSF).

Results

There were significant improvements in mean root mean square error values for corneal total HOA, total coma, anterior HOA, anterior coma, and vertical coma following CXL (P > 0.05, for all). No significant changes were found in the posterior aberometric parameters. PSF value did not change after CXL (P > 0.05). The corneal topographic measurements not revealed a change in the mean simulated keratometry-1, simulated keratometry-2, and maximum keratometry compared with the baseline measurements (P > 0.05, for all). At 12 months, there was a significant improvement in the uncorrected (UCVA) and best corrected (BCVA) visual acuity (P < 0.001, both). Most corneal aberrations correlated significantly with postoperative BCVA, but changes in HOAs were not statistically associated with improvements in visual acuity.

Conclusions

Transepithelial CXL was effective in stabilizing the keratometric indices and improving the most corneal aberrations in keratoconic eyes 1 year after the procedure. While the healing effect on aberrations after CXL was in total and anterior parameters, no significant changes were observed in the posterior surface. In addition, it was observed that transepithelial CXL treatment did not cause a significant change in PSF distribution data.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Kocaeli State Hospital, Kocaeli, Turkey

    Sebnem Kaya Ergen

  2. Department of Ophthalmology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey

    Sevgi Subaşı, Büşra Yılmaz Tuğan & Nurşen Yüksel

  3. Department of Ophthalmology, Acibadem Maslak Hospital, Istanbul, Turkey

    Özgül Altıntaş

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Sebnem Kaya Ergen and Sevgi Subasi. The first draft of the manuscript was written by Sebnem Kaya Ergen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sebnem Kaya Ergen.

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All procedures in this study were performed in accordance with the guidelines of the Declaration of Helsinki and were approved by the Local Ethics Committee of Kocaeli University (2021/328).

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Kaya Ergen, S., Subaşı, S., Yılmaz Tuğan, B. et al. The effect of transepithelial corneal collagen cross-linking treatment on optical quality of the cornea in keratoconus: 12-month clinical results. Int Ophthalmol 44, 146 (2024). https://doi.org/10.1007/s10792-024-03089-7

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