Abstract Introduction Objective markers describing corneal optical density (COD), thinnest corneal thickness (TCT), and anterior (ARC) and posterior (PRC) surface radii over the 3 mm thinnest region of the cornea were investigated to provide a model for estimating corrected distance visual acuity (CDVA) after corneal cross-linking (CXL) in keratoconus. Methods CDVA, COD, TCT, ARC, and PRC were monitored (using Pentacam™) over 1 year in patients with (1) keratoconus treated with routine CXL (2) relatively stable untreated keratoconus, and (3) age/gender-matched controls. Results In group 1 (n = 77), the median logMAR CDVA (mode, interquartile range) improved significantly (p