Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: Ten-year results

PURPOSE: To analyze the 10-year results of corneal collagen crosslinking (CXL) for keratoconus. SETTING: Department of Ophthalmology, University Hospital, Dresden, Germany. DESIGN: Retrospective interventional case series. METHODS: The study included eyes treated for progressive keratoconus from 2000 to 2004. Corneal collagen crosslinking was performed by applying riboflavin and ultraviolet-A. The corrected distance visual acuity (CDVA), corneal topography, and endothelial cell count (ECC) were recorded preoperatively and 10 years postoperatively. RESULTS: The study enrolled 24 patients (34 eyes). The mean age of the 18 men and 6 women was 28.4 years +/- 7.3 (SD) and the mean follow-up, 131.9 +/- 20.1 months. The mean apical keratometry (K) value was 61.5 diopters (D) preoperatively and 55.3 D 10 years postoperatively; the decrease was statistically significant (P<.001). The mean values for maximum K (53.2 D and 49.56 D, respectively) and minimum K (47.5 D and 45.5 D, respectively) were also significantly lower (P<.001). The preoperative and postoperative CDVA were statistically significantly different (P=.002). The mean CDVA improved by 0.14 logMAR over preoperatively; the change was statistically significant (P=.002). The ECC was unchanged. CONCLUSIONS: Corneal CXL was effective in treating progressive keratoconus, achieving long-term stabilization of the condition. It was easy to perform, had a good safety profile, and reduced the need for corneal transplantation.