Higher-order aberrations after corneal collagen crosslinking for keratoconus and corneal ectasia.
OBJECTIVE
To determine changes in higher-order aberrations (HOAs) after corneal collagen crosslinking (CXL).


METHODS
Cornea and refractive surgery practice.


METHODS
Prospective randomized controlled clinical trial.


METHODS
Corneal and ocular HOAs were measured and analyzed using the Pentacam device and Ladarwave aberrometer, respectively, at baseline and 12 months after CXL.


RESULTS
Ninety-six eyes (64 keratoconus, 32 ectasia) of 73 patients had CXL. A fellow-eye control group comprised 42 eyes. The mean preoperative total anterior corneal HOAs, total coma, 3rd-order coma, and vertical coma were 4.68 μm ± 2.33 (SD), 4.40 ± 2.32 μm, 4.36 ± 2.30 μm, and 4.04 ± 2.27 μm, respectively. At 1 year, the mean values decreased significantly to 4.27 ± 2.25 μm, 4.01 ± 2.29 μm, 3.96 ± 2.27 μm, and 3.66 ± 2.22 μm, respectively (all P<.001). There were no significant changes in posterior corneal HOAs. The mean preoperative total ocular HOAs, total coma, 3rd-order coma, trefoil, and spherical aberration were 2.80 ± 1.0 μm, 2.60 ± 1.03 μm, 2.57 ± 1.03 μm, 0.98 ± 0.46 μm, and 0.90 ± 0.42 μm, respectively. At 1 year, the mean values decreased significantly to 2.59 ± 1.06 μm, 2.42 ± 1.07 μm, 2.39 ± 1.07 μm, 0.88 ± 0.49 μm, and 0.83 ± 0.38 μm, respectively (all P=.01). After CXL, HOAs were significantly improved compared with the control group. Changes in HOAs were not statistically associated with an improvement in visual acuity or most subjective visual symptoms, however.


CONCLUSIONS
Corneal and ocular HOAs decreased after CXL, suggesting an improvement in corneal shape.
Cornea and Laser Eye Institute-Hersh Vision Group, CLEI Center for Keratoconus, Teaneck, and Department of Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey 07666, USA.
Steven A
SA
Greenstein
Kristen L
KL
Fry
Matthew J
MJ
Hersh
Peter S
PS
Hersh
D057128:Aberrometry; D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000187:drug effects* / Q000378:metabolism; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D003432:Cross-Linking Reagents; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D020731:Keratomileusis, Laser In Situ; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011183:Postoperative Complications; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin