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Purpose.  To analyze the outcomes and difference after UVA/riboflavin corneal collagen crosslinking (CXL) in four different corneal thickness groups of patients with progressive keratoconus.  Methods.  Retrospective study. Eyes with progressive keratoconus after CXL were divided into 4 subgroups as follows: group 1, thinnest corneal thickness (TCT) ≤ 400  µ m; group 2, 400  µ m < TCT ≤ 450  µ m; group 3, 450  µ m < TCT ≤ 500  µ m; group 4, TCT ≥ 500  µ m. Baseline, 6-month, and 12-month visual acuity, corneal topography, TCT, and endothelial cell density were evaluated.  Results.  The analysis included 123 eyes of 101 patients. At 6 and 12 months after CXL, there was a mean improvement about visual acuity and keratometry values in all patients. There was a reduction in the change of maximum keratometry ( K  max ) with the increase of TCT. After 1 year of treatment, it was 3.04 ± 0.75 D in group 1, 2.38 ± 0.51 D in group 2, 1.57 ± 0.35 D in group 3, and 0.31 ± 0.20 D in group 4.  Conclusion.  CXL is successful in halting the progression of keratoconus and there was a negative linear correlation between TCT and  K  max . Advanced cases of progressive keratoconus seemed to obtain more benefits from the flatting effects of CXL.

Thinner Corneas Appear to Have More Striking Effects of Corneal Collagen Crosslinking in Patients with Progressive Keratoconus