Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis

Abstract Introduction Corneal cross linking (CXL) is an appropriate method to treat progressive keratoconus in order to stop progression. Generally, the change in the maximum corneal power (Kmax), corneal thickness, and total astigmatism are assessed for progression analysis. The aim of this study i...

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Main Authors: Susanne Marx-Gross, Anne J. Winter, Daniel Wollschlaeger, Paul-Rolf Preussner
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-03-01
Series:Ophthalmology and Therapy
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Online Access:https://doi.org/10.1007/s40123-025-01121-2
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author Susanne Marx-Gross
Anne J. Winter
Daniel Wollschlaeger
Paul-Rolf Preussner
author_facet Susanne Marx-Gross
Anne J. Winter
Daniel Wollschlaeger
Paul-Rolf Preussner
author_sort Susanne Marx-Gross
collection DOAJ
description Abstract Introduction Corneal cross linking (CXL) is an appropriate method to treat progressive keratoconus in order to stop progression. Generally, the change in the maximum corneal power (Kmax), corneal thickness, and total astigmatism are assessed for progression analysis. The aim of this study is to answer the question of whether corneal astigmatism is suitable for quantifying keratoconus progression or demonstrating stability. To improve accuracy, we analyze astigmatism as a vector parameter in CXL follow-up. Methods We performed a retrospective observational study analyzing a total of 74 eyes diagnosed with progressive keratoconus that received CXL treatment and had a follow-up period of at least 12 months, and in some cases, up to 5 years. In the Scheimpflug imaging examination (Pentacam®), the focus was on the change of Kmax in diopter (D), astigmatism of the corneal front, and its vector parameter. Results Preoperatively, we observed an increase in Kmax difference (KmaxD) (median +1.9 D ± standard deviation, SD 2.2) and astigmatism vector difference (AVD) (median +0.7 D ± SD 1.6) with a positive correlation, which establishes a treatment indication. The follow-up showed a stabilization of KmaxD and AVD after 12 months (median KmaxD −0.7 D, AVD −0.4), and over the periods of 3 and 5 years, a further stabilization of the curvature parameters with a lower number of cases. Conclusions Compared with an analysis of an absolute value only, the vector analysis of astigmatism allows a much more precise description of astigmatism in order to verify the effectiveness of CXL. Both astigmatism vector and Kmax preoperatively increased and stabilized potstoperatively. Astigmatism presumably has a significant effect on the quality of vision and should therefore also be used as an additional stability factor beside Kmax.
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spelling doaj-art-c0288c995a2a4b3b8bdd6d2b4acc5f712025-08-20T02:24:26ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-03-011451081109610.1007/s40123-025-01121-2Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector AnalysisSusanne Marx-Gross0Anne J. Winter1Daniel Wollschlaeger2Paul-Rolf Preussner3Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University MainzDepartment of Ophthalmology, University Medical Center of the Johannes Gutenberg-University MainzUniversity Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Radiation EpidemiologyDepartment of Ophthalmology, University Medical Center of the Johannes Gutenberg-University MainzAbstract Introduction Corneal cross linking (CXL) is an appropriate method to treat progressive keratoconus in order to stop progression. Generally, the change in the maximum corneal power (Kmax), corneal thickness, and total astigmatism are assessed for progression analysis. The aim of this study is to answer the question of whether corneal astigmatism is suitable for quantifying keratoconus progression or demonstrating stability. To improve accuracy, we analyze astigmatism as a vector parameter in CXL follow-up. Methods We performed a retrospective observational study analyzing a total of 74 eyes diagnosed with progressive keratoconus that received CXL treatment and had a follow-up period of at least 12 months, and in some cases, up to 5 years. In the Scheimpflug imaging examination (Pentacam®), the focus was on the change of Kmax in diopter (D), astigmatism of the corneal front, and its vector parameter. Results Preoperatively, we observed an increase in Kmax difference (KmaxD) (median +1.9 D ± standard deviation, SD 2.2) and astigmatism vector difference (AVD) (median +0.7 D ± SD 1.6) with a positive correlation, which establishes a treatment indication. The follow-up showed a stabilization of KmaxD and AVD after 12 months (median KmaxD −0.7 D, AVD −0.4), and over the periods of 3 and 5 years, a further stabilization of the curvature parameters with a lower number of cases. Conclusions Compared with an analysis of an absolute value only, the vector analysis of astigmatism allows a much more precise description of astigmatism in order to verify the effectiveness of CXL. Both astigmatism vector and Kmax preoperatively increased and stabilized potstoperatively. Astigmatism presumably has a significant effect on the quality of vision and should therefore also be used as an additional stability factor beside Kmax.https://doi.org/10.1007/s40123-025-01121-2KeratoconusCrosslinking (CXL)Astigmatism vector analysisPostoperative follow upProgression
spellingShingle Susanne Marx-Gross
Anne J. Winter
Daniel Wollschlaeger
Paul-Rolf Preussner
Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
Ophthalmology and Therapy
Keratoconus
Crosslinking (CXL)
Astigmatism vector analysis
Postoperative follow up
Progression
title Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
title_full Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
title_fullStr Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
title_full_unstemmed Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
title_short Influence of Crosslinking on Astigmatism Vector in Keratoconus: A Vector Analysis
title_sort influence of crosslinking on astigmatism vector in keratoconus a vector analysis
topic Keratoconus
Crosslinking (CXL)
Astigmatism vector analysis
Postoperative follow up
Progression
url https://doi.org/10.1007/s40123-025-01121-2
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