Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study

Abstract Objective To evaluate the refractive, keratometric, and biomechanical changes in keratoconus patients following modified accelerated corneal cross-linking (A-CXL). Methods This retrospective observational study analyzed clinical data from patients with progressive keratoconus who underwent...

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Main Authors: Robert Edward T. Ang, Alvin Joseph A. Guloy, Emerson M. Cruz, Jimmy Jarvis Gene C. Lo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04195-5
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author Robert Edward T. Ang
Alvin Joseph A. Guloy
Emerson M. Cruz
Jimmy Jarvis Gene C. Lo
author_facet Robert Edward T. Ang
Alvin Joseph A. Guloy
Emerson M. Cruz
Jimmy Jarvis Gene C. Lo
author_sort Robert Edward T. Ang
collection DOAJ
description Abstract Objective To evaluate the refractive, keratometric, and biomechanical changes in keratoconus patients following modified accelerated corneal cross-linking (A-CXL). Methods This retrospective observational study analyzed clinical data from patients with progressive keratoconus who underwent modified A-CXL with a prolonged riboflavin imbibition period prior to UV irradiation. Preoperative and post-operative data on vision, refraction, tomography using OCULUS Pentacam and biomechanics using Corvis ST were analyzed at various follow-up intervals. Subgroup analysis was conducted based on topographic keratoconus classification. Statistical comparison was performed to assess changes in these parameters over time. Results A total of 70 eyes of 55 patients were included. A statistically significant improvement in mean change of logMAR BCVA was noted at 6 and 12 months (p = 0.006 and p = 0.018). Six months following A-CXL, statistically significant improvements were observed in keratometry and pachymetry (p = 0.003 and p < 0.001). Mean changes in biomechanical parameters deformation amplitude ratio (DAR) and Integrated Radius (IR) were found to be significantly decreased at 6 months (p = 0.001 and p = 0.011). Other biomechanical parameters SPA1, SSI and ARTh had no significant changes suggesting stability. Comparative analysis between different stages of keratoconus revealed that patients classified under TKC-4 exhibited greater improvement in keratometry compared to those with TKC-2 and TKC-3 staging. Conclusion A-CXL with extended riboflavin exposure was effective in stabilizing both tomographic and biomechanical parameters which resulted in increased corneal stiffness and maintained stability. All KC stages demonstrated corneal stability following A-CXL.
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spelling doaj-art-fb965fe1f34f4802b4fa6c215e15e6fa2025-08-20T04:01:26ZengBMCBMC Ophthalmology1471-24152025-07-0125111710.1186/s12886-025-04195-5Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational studyRobert Edward T. Ang0Alvin Joseph A. Guloy1Emerson M. Cruz2Jimmy Jarvis Gene C. Lo3Asian Eye InstituteCardinal Santos Medical CenterAsian Eye InstituteAsian Eye InstituteAbstract Objective To evaluate the refractive, keratometric, and biomechanical changes in keratoconus patients following modified accelerated corneal cross-linking (A-CXL). Methods This retrospective observational study analyzed clinical data from patients with progressive keratoconus who underwent modified A-CXL with a prolonged riboflavin imbibition period prior to UV irradiation. Preoperative and post-operative data on vision, refraction, tomography using OCULUS Pentacam and biomechanics using Corvis ST were analyzed at various follow-up intervals. Subgroup analysis was conducted based on topographic keratoconus classification. Statistical comparison was performed to assess changes in these parameters over time. Results A total of 70 eyes of 55 patients were included. A statistically significant improvement in mean change of logMAR BCVA was noted at 6 and 12 months (p = 0.006 and p = 0.018). Six months following A-CXL, statistically significant improvements were observed in keratometry and pachymetry (p = 0.003 and p < 0.001). Mean changes in biomechanical parameters deformation amplitude ratio (DAR) and Integrated Radius (IR) were found to be significantly decreased at 6 months (p = 0.001 and p = 0.011). Other biomechanical parameters SPA1, SSI and ARTh had no significant changes suggesting stability. Comparative analysis between different stages of keratoconus revealed that patients classified under TKC-4 exhibited greater improvement in keratometry compared to those with TKC-2 and TKC-3 staging. Conclusion A-CXL with extended riboflavin exposure was effective in stabilizing both tomographic and biomechanical parameters which resulted in increased corneal stiffness and maintained stability. All KC stages demonstrated corneal stability following A-CXL.https://doi.org/10.1186/s12886-025-04195-5KeratoconusAccelerated corneal collagen cross linkingRefractive changesKeratometryCorneal biomechanics
spellingShingle Robert Edward T. Ang
Alvin Joseph A. Guloy
Emerson M. Cruz
Jimmy Jarvis Gene C. Lo
Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
BMC Ophthalmology
Keratoconus
Accelerated corneal collagen cross linking
Refractive changes
Keratometry
Corneal biomechanics
title Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
title_full Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
title_fullStr Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
title_full_unstemmed Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
title_short Evaluation of refractive, tomographic and biomechanical changes after customized accelerated corneal collagen cross-linking in keratoconus patients: a retrospective observational study
title_sort evaluation of refractive tomographic and biomechanical changes after customized accelerated corneal collagen cross linking in keratoconus patients a retrospective observational study
topic Keratoconus
Accelerated corneal collagen cross linking
Refractive changes
Keratometry
Corneal biomechanics
url https://doi.org/10.1186/s12886-025-04195-5
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