The effect of cross-linking procedure on corneal wavefront aberrations in patients with keratoconus

Background/Aim: The aim of our study was to assess the impact of cross-linking (CXL) on the keratoconus regarding higher-order aberrations (HOAs) and potential improvement of visual function. Methods: In 19 patients a standard epithelium-off CXL was performed with an energy density of 3 mW/cm2 for half an hour. The cornea was examined by Pentacam topography before, one and six months after CXL. Best-corrected visual acuity (BCVA), topographic data and aberrations were collected. Results: A significant reduction in vertical coma was observed from preoperative -1.03 ? 1.89 to -0.74 ? 1.73 (p=0.004) 6 months after CXL, and in spherical aberration from preoperative -0.22 ? 1.05 to -0.08 ? 1.13 (p=0.002) 6 months after CXL. RMS-HOA 6 months after CXL also showed a significant reduction from 2.31 ? 1.82 to 2.26 ? 1.84 6 months after CXL (p=0.001). BCVA improved from preoperative 0.43 ? 0.15 to 0.71 ? 0.19 6 months after surgery (p<0.001). Conclusion: CXL is a very potent treatment method for keratoconus, which significantly reduces certain corneal wavefront aberrations, especially vertical coma, spherical aberration and RMS, and leads to a significant improvement in visual acuity.