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ABS TRACT Objective: To evaluate the long-term clinical outcomes (minimum follow-up period of 2 years) of accelerated crosslinking (CXL) at 18 mW/cm2 for 5 minutes, in patients with progressive keratoconus. Material and Methods: Thirty five eyes of 35 patients with progressive keratoconus who underwent accelerated CXL were included. Topographical measurements were obtained using a rotating Scheimpflug camera (Sirius). Flat Keratometry (K) value (K1), steep K value (K2), average K value (avgK), topographic cylindrical value (Cyl), apical keratoscopy front (AKf or Kmax), apical keratoscopy back (AKb), symmetry index front (SIf), symmetry index back (SIb), central corneal thickness (CCT), thinnest point of the cornea (Thin), and total corneal volume (CV) were recorded from the topography data generated by the Scheimpflug system. Results: The uncorrected and best corrected visual acuity of the patients had begun to increase significantly after 6 months postoperatively (p=0.014 and p=0.0001, respectively) and continued to improve in the 12th and 24th months (p<0.05 for all). There was a statistically significant but temporary increase in keratometric values of K2, avgK and AKf at 1 month postoperative (p=0.0001, p=0.008, and p=0.001, respectively), but K2 and avgK did not show any statistically significant difference in the other follow-up visits (p>0.05 for all). Flat keratometry value decreased significantly at 24 months (p=0.029) and, AKf improved significantly at 12 and 24 months (p=0.029 and p=0.001, respectively). Conclusion: The accelerated CXL procedure (18 mW/cm2 for 5 minutes) is effective in preventing keratoconus progression with increased visual acuity and stabilization in keratometric values after the 2-year follow-up.

Accelerated (18 mW/cm2 for 5 Minutes) Corneal Collagen Cross-Linking for Progressive Keratoconus: Two-Year Results