March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Long-term Results Of Cross-linking Treatment For Progressive Keratoconus
Author Affiliations & Notes
  • Dan Epstein
    Ophthalmology, Universitaets Spital Zurich, ZUrich, Switzerland
  • Elena Albè
    Ophthalmology, Istituto Clinico Humanitas, Milan, Italy
  • Riccardo Vinciguerra
    Ophthalmology, Istituto Clinico Humanitas, Milan, Italy
  • Paolo Vinciguerra
    Ophthalmology, Istituto Clinico Humanitas, Milan, Italy
  • Footnotes
    Commercial Relationships  Dan Epstein, None; Elena Albè, None; Riccardo Vinciguerra, None; Paolo Vinciguerra, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6820. doi:
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      Dan Epstein, Elena Albè, Riccardo Vinciguerra, Paolo Vinciguerra; Long-term Results Of Cross-linking Treatment For Progressive Keratoconus. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6820.

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      © ARVO (1962-2015); The Authors (2016-present)

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To assess the long-term outcomes after cross-linking treatment of progressive keratoconus.


Ninety-seven eyes of adult patients with topographically and tomographically documented progressive keratoconus were treated with cross-linking (CXL). The standard treatment procedure was used, applying riboflavin 0.1% following epithelial abrasion. The corneas were then irradiated with UVA light. The eyes were monitored for a minimum of 36 months. Best spectacle correction visual acuity (BSCVA), refraction, topography, tomography and aberrations were documented at regular intervals. In addition, postoperative BSCVA results for different age groups were compared with a cohort of CXL-treated pediatric eyes.


At 36 months after CXL, mean BSCVA had significantly (p<0.05) improved from 0.47±0.29 to 0.73±0.24 (decimal scale). Sixty-one percent of the eyes had gained 2 or more lines of BSCVA by the three-year follow-up. Mean spherical equivalent refraction had improved from -3.74D to -2.76D. Mean cylinder was lowered from -2.69D to -2.13D. Topography maps exhibited a statistically significant (p40 improved from 0.57 to 0.73 (all adults over a 3-year period).


This 3-year follow-up provides further evidence that corneal cross-linking is effective in arresting progressive keratoconus. CXL appears to stabilize keratoconus even long term. The improvement of BSCVA is likely due to the significant reduction of corneal asymmetry and wavefront aberrations. BSCVA improved in all age groups studied.

Keywords: keratoconus • cornea: clinical science 

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