Corneal parameters 18 Months following collagen cross-linkage treatment (CXL) for keratoconus in western Saudi Arabia: A prospective cohort study

Abstract

Introduction keratoconus is a common disease in the general population, with prevalence ranging up to 200 per 100 000 with a reported increase in Saudi Arabia. Collagen Cross-Linkage is now an established treatment in isolation and in conjunction with other modalities for managing keratoconus. Our aim is to evaluate using a cohort study the impact of the treatment over a course of 18 months. Methods To evaluate the impact of 18 months after collagen cross-linkage treatment and its determinants in eyes with keratoconus in Western Saudi Arabia. A one-armed prospective cohort study design on 45 patients with Stage I, II, III and IV keratoconus who were treated by Collagen Cross-Linkage modality was developed at our institute between 2018 and 2019 to establish the success rate of corneal ectasia stabilization of the disease. Results Demographic data and grades of keratoconus (Amsler - Krumiech classification) at presentation were correlated to changes in corneal parameters 18 months after CXL compared to that at presentation. Stage I, II, III and IV keratoconus were 13, 14, 2 and 16 eyes respectively. The study showed that the K max significantly declined (P = 0.05) while spherical equivalent refractive status changed from median −1.5D to −2.27D (P = 0.002). Meanwhile, Central corneal thickness significantly reduced (P = 0.001). Conclusion CXL can prove to be efficient in the treatment of Keratoconus and more studies should study ways to improve and implement this treatment plan to such patients.