Outcome of accelerated corneal cross-linking with 0.25% riboflavin in progressive keratoconus patients.

BACKGROUND

To present the one-year outcomes of accelerated corneal collagen cross-linking (CXL) with 0.25% riboflavin in the management of progressive keratoconus in the East Asian population.

METHODS

A retrospective analysis was performed on twenty-four patients (32 eyes) diagnosed with progressive keratoconus treated in Taiwan. Exclusion criteria included corneas with a stromal thickness of less than 400 μm. A 15-min soak with 0.25% riboflavin was followed by UVA light exposure at 18 mW/cm2 for 5 min, achieving a total energy of 5.4 J/cm2. Corrected distance visual acuity, corneal topography, subjective refraction, endothelial cell density, corneal thickness were evaluated at baseline, 1, 3, 6, and 12 months postoperatively. The primary efficacy criterion was the changes in maximum keratometry (Kmax) at the 12-month follow-up.

RESULTS

The mean Kmax decreased from 61.74 ± 9.9 to 60.05 ± 9.1 D at one-year follow-up (P = 0.002). Central corneal pachymetry decreased significantly from 464.16 ± 28.6 to 442.73 ± 87.6 μm (P < 0.001) at one year. The mean demarcation line depth was 375.91 ± 53.4 μm at one-month follow-up. Mean corrected distance visual acuity, manifest refraction and endothelial cell density remained unchanged.

CONCLUSIONS

Our findings demonstrate the safety and efficacy of accelerated CXL with 0.25% riboflavin for progressive keratoconus, providing an effective option in clinical management.

TRIAL REGISTRATION: This study retrospectively registered and approved by the Institutional Review Board (IRB) of the Shin Kong Wu Ho-Su Memorial Hospital. (IRB number: 20240403R).