Corneal stability and visual acuity 1 year after corneal cross-linking assessed using the ABCD keratoconus staging system

PURPOSE: To assess corneal stability and corrected distance visual acuity (CDVA) 3, 6, and 12 months following corneal crosslinking (CXL) using the ABCD keratoconus staging system. METHODS: This prospective longitudinal study included 31 eyes with keratoconus receiving CXL based on the standard Dresden protocol. CDVA, refraction, and Scheimpflug tomography with the Pentacam HR (Oculus Optikgeräte GmbH) were evaluated before and after surgery. Geometric and functional changes were assessed using the actual values and staging of each element of the ABCD keratoconus staging system. A, B, C, and D refer to the anterior and posterior radii of curvature in a 3-mm zone centered on the corneal thinnest point, minimum corneal thickness, and CDVA, respectively. RESULTS: There were no significant changes in the actual values of anterior radius of curvature (P = .497) and CDVA (P = .082), whereas posterior radius of curvature (P = .007) and corneal thinnest point (P < .001) showed significant changes statistically. Pairwise comparison showed only a statistically significant steepening in posterior radius of curvature at 3 months after CXL compared to the preoperative radius (P = .002) and a significant decrease in corneal thinnest point at 3 (P < .001) and 6 (P = .028) months after CXL compared to baseline assessment. Staging of each element of the ABCD keratoconus staging system indicated no change between baseline and 3, 6, and 12 months after CXL. CONCLUSIONS: The geometric and functional parameters included in the ABCD keratoconus staging system showed stability of corneal status and CDVA 1 year after CXL.