BMC Ophthalmology · 4 authors, 1 centre
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A prospective case series of 45 eyes with mild to moderate keratoconus underwent accelerated pulsed high-fluence corneal cross-linking, and specular microscopy at 3 and 6 months postoperatively showed no significant changes in endothelial cell density or morphological parameters.
This prospective case series enrolled 45 eyes of 27 patients with mild to moderate progressive keratoconus (mean age 24.89 ± 7.21 years) who underwent accelerated pulsed high-fluence epithelium-off CXL. Specular microscopy assessed endothelial parameters preoperatively and at 3 and 6 months postoperatively; AS-OCT measured demarcation line depth at 1 month. The mean preoperative ECD of 2944.6 ± 247.41 cell/mm² showed a non-significant reduction at 3 months (2931.03 ± 253.82 cell/mm²) and 6 months (2924.7 ± 224.88 cell/mm²), with P = 0.361. No significant changes were observed in coefficient of variation, hexagonal cell percentage, or endothelial cell sizes at either timepoint. The mean demarcation line depth at 1 month was 214 ± 17.43 μm. Limitations include the small sample size, short follow-up period, and lack of comparison with other CXL protocols.
