5-year data shows CXL effective in keratoconus

This prospective study found that corneal collagen cross-linking (CXL) was safe and effective for the treatment for progressive keratoconus through five years of follow-up.

This study is a significant contribution to the literature for CXL as it demonstrates treatment stability over five years, mirroring earlier reports with shorter follow-ups. However, the lack of a control group and small study size of 32 patients limit the generalizability of the results. For instance, the study is not sufficiently powered to draw conclusions regarding long-term safety for rare complications, such as treatment-associated keratitis. Nevertheless, it adds to the growing literature suggesting that CXL is a promising new treatment modality for progressive cornea ectasias.

The authors evaluated the long-term results of CXL in 32 patients with progressive keratoconus. The patients underwent CXL no later than one month after baseline examinations. During CXL treatment, ultraviolet irradiation was applied for 30 minutes during which riboflavin instillation was repeated every three minutes.

Mean BCVA improved significantly within the first year following CXL but did not change significantly after that. At five years’ follow-up, mean UCVA had improved slightly. By the fifth-year follow-up, mean MRSE had decreased by 12.89 percent compared with baseline, which was not significant, and mean max-K and mean-K  showed slight, insignificant decreases compared with baseline (0.24 and 0.11 D, respectively).

The authors concluded that CXL halts the progression of keratectasia.