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Purpose:  To investigate the safety and efficacy of topography-guided transepithelial accelerated corneal collagen cross-linking for low refractive error correction in patients with keratoconus.   Methods:  This was a prospective self-controlled study. Eighteen patients (18 eyes) were enrolled and assessed at 6 visits (pre-operation, 1 w, 1 month, 3 months, 6 months, and 1 year postoperatively). The examination at every visit included analysis of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), corneal topography, and corneal endothelial cell counts. Data are expressed as mean ± standard deviation (SD). The  p -value was determined using repeated-measures analysis of variance.   Results:  No complications occurred in any eye during 1 year follow-up period. At each visit after the operation, the corneal K values and spherical equivalent (SE) were reduced, while the visual acuity values were increased compared with those preoperatively, although these results were not statistically significant ( p  &amp;gt; 0.05). UCVA of nearly 1/3 of the patients was enhanced by at least 3 lines at each follow-up visit. During the whole follow-up, corneal endothelial cell counts were stable ( p  &amp;gt; 0.05). Regarding topography, part of the corneal cone was flattened after the operation.   Conclusion:  Topography-guided transepithelial-accelerated corneal collagen cross-linking is safe and may correct low refractive error in keratoconus treatment. Further studies and improvements are required in this regard.

frontiers in bioengineering and biotechnology

Topography-Guided Transepithelial Accelerated Corneal Collagen Cross-Linking for Low Refractive Error Correction in Keratoconus Treatment: A Pilot Study