Corneal collagen crosslinking for progressive keratoconus in Saudi Arabia: One-year controlled clinical trial analysis

Aims: To determine the short-term efficacy of corneal collagen crosslinking (CXL) treatment in patients with progressive Keratoconus (KCN) in comparison with no treatment. Settings and design: This controlled clinical trial study was carried out at a tertiary eye hospital, Eastern Province, Saudi Arabia. Methods and material: A prospective controlled clinical study of patients being treated for Keratoconus at a tertiary eye care hospital in the Eastern province of Saudi Arabia. 51 eyes of 43 patients with progressive KCN who received corneal collagen crosslinking (treatment group) and 50 eyes of 34 patients with KCN and no treatment (control group) were included in our study. A one year clinical data were collected preoperatively as well as at 1, 3, 6 and 12 months postoperatively for the treatment group patients. A baseline and 1 year clinical data were collected for the control group patients. The short-term efficacy of the treatment in preventing progression of KCN in comparison with no treatment was analysed at one year. Results: At one year after crosslinking, there was significant flattening of the average keratometry by 0.61 D (p = 0.001) [95% CI: 0.25, 0.97] compared to 0.40 D (p = 0.210) steepening in the control group; difference between treatment and control was 1.01 D (p = 0.006) [95% CI: 0.29, 1.72]. Pachymetry in treatment group thinned by 20.21 mu m (p < 0.0001) [95% CI: 12.77, 27.66] compared to 0.32 mu m (p = 0.912) in the control group. Visual acuity remained stable at the preoperative level of 20/30 (p = 0.397) in the treatment group and 20/40 (p = 0.553) in the control group at one year. Conclusions: Corneal CXL is an effective treatment for halting the progression of KCN as shown by reduced keratometry and stability of vision.