Long term safety and efficacy of corneal cross-linking in patients affected by keratoconus

Background/Objectives:Large retrospective study evaluating the effectiveness and safety of corneal collagen cross-linking (CXL)Subjects/Methods: 886 eyes with progressive keratoconus were enrolled in a retrospective cohort study in a tertiary care university hospital. CXL was performed using a standardised technique (Dresden protocol: 0.1% riboflavin solution containing dextran 20% for 30 minutes during the soaking phase followed by 30 minute ultraviolet A irradiation (3mW/cm2)). Visual outcomes, maximum keratometry (Kmax), demarcation line measurements, and complications were recorded.Results:Uncorrected visual acuity (UCVA) improved from 0.49 ± 0.38 LogMAR to 0.47 ± 0.39 LogMAR (p=0.03, n=610) three years after the procedure, while best spectacle corrected visual acuity (BSCVA) improved from 0.15 ± 0.14 LogMAR to 0.14 ± 0.15 LogMAR (p=0.007, n=610). A significant reduction of Kmax from 56.28 ± 6.10 to 54.98 ± 6.19 (p