Evaluation of Corneal Tomographic, Densitometric, and Aberrometric Features Following Accelerated Corneal Cross-Linking in progressive keratoconus

Abstract Purpose To evaluate the 12 months' changes in tomographic, densitometric, and aberrometric parameters in keratoconic eyes after accelerated corneal cross-linking (CCL) and classify a densitometric course in different stages of the keratoconus separately (Mild, moderate, and severe). Methods In a prospective observational study, 67 keratoconic eyes of 67 patients that underwent accelerated epithelium-off corneal cross-linking (9 mW/cm2 and 10 minutes) for treatment of progressive keratoconus were included. Corneal tomographic, densitometric, and aberrometric values obtained using the Pentacam HR were recorded at the baseline and 3, 6, and 12 months post-operatively. Result One year after treatment, corrected distance visual acuity (CDVA) was improved, and maximum keratometry, thinnest pachymetry, higher order, and total Root Mean Square (RMS) were significantly decreased. (p < 0.001) Corneal densitometry values showed a significant elevation 3 months post-surgery compared to baseline and then decreases to baseline values at 1 year. Only the Anterior 0–2 mm zone densitometry at the third month was different between the three groups. RMS at 1 year correlated with Anterior 0–2 mm, Anterior 2–6 mm, total corneal 0–2 mm, and total corneal 2–6 mm densitometry values in the third month. Final CDVA at 12th-month follow-up correlated with the Anterior 0–2 mm corneal densitometry in the third month. Conclusion Anterior 0–2 mm zone densitometry at the third-month post accelerated CCL can be used to detect different staging of keratoconus. Due to the correlation between final aberrometric and peak densitometric values in keratoconic eyes, peak densitometric values can be used as a prognostic factor for the final visual outcomes after accelerated CCL.