Vol. 7 Issue 2 Part A

Author(s): Sanjana Garg

Abstract:
Keratoconus is a progressive condition characterized by thinning and protrusion of the cornea, leading to visual impairment due to irregular curvature. Corneal collagen cross-linking has emerged as a promising therapeutic intervention aimed at stabilizing the cornea and halting disease progression. This study was conducted to evaluate the long-term clinical outcomes of corneal collagen cross-linking in patients with progressive keratoconus over a period of eighteen months. A prospective and retrospective observational study was undertaken involving patients diagnosed with progressive keratoconus. All patients underwent corneal collagen cross-linking using riboflavin and ultraviolet light following a standard protocol (Dresden Protocol). Parameters assessed at baseline and at six, twelve, and eighteen months post-procedure included maximum and mean corneal curvature, central and thinnest corneal thickness, manifest and topographic astigmatism, and distance and near visual acuity. A total of thirty two eyes were studied. At 6 months post-C3R, there was a significant reduction in K-max across all stages of keratoconus, particularly in stages 1 and 2, indicating early corneal stabilization. Manifest astigmatism also showed notable improvement in stage 1 during this period. By 12 months, the reduction in K-max remained stable in stages 1 and 2 but was not sustained in stage 3, and further improvement in astigmatism was observed. At 18 months, over half of the eyes demonstrated regression in K-max, with a smaller proportion showing progression or stability. BCVA remained stable or improved in the majority of eyes, and near visual acuity was largely preserved. This study concludes that corneal collagen cross-linking is effective in halting the progression of keratoconus while offering improvement or stabilization in corneal shape and visual outcomes with the most pronounced benefits occurring within the first 6 to 12 months and largely sustained through 18 months. Early-stage patients tend to benefit the most, highlighting the importance of timely diagnosis and intervention. The procedure is safe, minimally invasive, and has the potential to reduce the need for corneal surgery in advanced cases.

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