Comparison of Visual and Tomographic Outcomes of Epithelium-On and Epithelium-Off Accelerated Corneal Crosslinking: A Longitudinal Study.

PURPOSE: To compare the visual and tomographic outcomes of epithelium-on and epithelium-off corneal collagen crosslinking (CXL) in an accelerated protocol in eyes with progressive keratoconus.

METHODS

Sixty-one patients with progressive keratoconus (female patients, n = 30; male patients, n = 31) aged 17 and 48 years (mean age: 25.8 ± 6.2 yrs) were included in this study. Patients underwent either epithelium-off (n = 27) or epithelium-on (n = 34) CXL using an accelerated protocol. Patients with at least 12 months of follow-up were included in the study. Visual and tomographic data from 3, 6, and 12 months after surgery were analyzed.

RESULTS

There were no differences between the visual and tomographic characteristics of the epithelium-on and epithelium-off groups at baseline (P > 0.05). No significant changes in uncorrected and best spectacles-corrected visual acuity were found at any stage during the first 12 months within either group or between the groups (all P > 0.05). There were no changes in thickness and keratometric parameters at any stage during the first 12 months within either group, or between groups (P > 0.05) except for a transient significant thinning of the central cornea in all groups in the first 3 months which recovered by 6 months. There was no significant difference between groups regarding the number of eyes with progression in the 12 months after treatment (P > 0.05).

CONCLUSIONS

Epithelium-on and epithelium-off CXL in an accelerated protocol provide comparable visual and tomographic outcomes after 1 year in eyes with progressive keratoconus.