One-year non-comparative observational study to evaluate corneal tomographic, densitometric, and aberrometric features following accelerated corneal cross-linking in progressive keratoconus.

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 min) 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. RESULTS: 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 decreased to baseline values at 1 year. Only the Anterior 0-2 mm zone densitometry at the 3rd 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 3rd month. Final CDVA at 12th month follow-up correlated with the Anterior 0-2 mm corneal densitometry in the 3rd month. CONCLUSION: Anterior 0-2 mm zone densitometry at the 3rd-month post-accelerated CCL is different in various stages 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.