Flattening effect of corneal cross-linking depends on the preoperative severity of keratoconus

Kozue Kasai, Naoko Kato, Kenji Konomi, Megumi Shinzawa, Jun Shimazaki

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


A retrospective observational study was conducted to validate the effect of corneal cross-linking (CXL) on eyes with progressing keratoconus, depending on severity. In total, 45 eyes of 33 patients (age: 23.9 ± 6.8 years, range: 14-42 years) with progressive keratoconus who underwent CXL were enrolled. Examinations were performed at pre-, 1, 3, 6, and 12 months after surgery. In addition to a slit lamp microscopy, measurement of visual acuity, the steepest keratometric value (Kmax), the thinnest corneal thickness (TCT), and the corneal endothelial cell density (ECD) were assessed. Change in Kmax (ΔKmax) was calculated by subtracting the preoperative Kmax from the 12-month postoperative Kmax. CDVA, TCT, and ECD did not change significantly throughout the follow-up period. Kmax was 56.4 ± 7.2 D preoperatively and 54.3 ± 5.6 D at 12 months after CXL (P = .174). The average value of ΔKmax was -2.23 ± 4.31 D at 12 months after CXL. ΔKmax was negatively correlated with preoperative Kmax (ρ = -0.5517, P = .0001), and positively correlated with preoperative TCT (ρ = 0.4791, P = .0012). However, no correlation was observed between Kmax and patient age or the decrease ratio of ECD. The more flattening was obtained after CXL in cases with the more advanced keratoconus. No complication, including corneal endothelial damage, was observed even in advanced cases.

Original languageEnglish
Article numbere8160
JournalMedicine (United States)
Issue number40
Publication statusPublished - 2017 Oct 1


  • advanced keratoconus
  • corneal cross-linking
  • keratoconus management
  • the later stages

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of 'Flattening effect of corneal cross-linking depends on the preoperative severity of keratoconus'. Together they form a unique fingerprint.

Cite this