title: Corneal Collagen Cross-Linking in the Treatment of Progressive Keratoconus: A Randomized Controlled Contralateral Eye Study.
abstract: BACKGROUND
  To assess the short-term efficacy and safety of corneal collagen cross-linking (CXL) in preventing the progression of keratoconus (KCN).
  
  
  METHODS
  This randomized controlled clinical trial enrolled 26 patients diagnosed with bilateral progressive KCN and were eligible for CXL. In each patient, one eye was randomly selected for treatment, and the contralateral eye served as the control. The patients underwent CXL with riboflavin drops and ultraviolet radiation in the treated eye. One year follow-up data are presented. Postoperatively, patients were assessed for progression of KCN, visual changes, and other findings. The main outcome measures were maximum simulated keratometry (K-max), best spectacle-corrected visual acuity (BSCVA), and average simulated keratometry. P <0.05 was considered as statistically significant.
  
  
  RESULTS
  In the treated eyes, the mean K-max values decreased by 0.22 D at 1-year postoperatively and increased by 0.41 D in the control group. This difference was statistically significant (P < 0.001). BSCVA improved slightly (a decrease of 0.13 LogMAR) and decreased slightly in the control group (a 0.01 LogMAR increase). The difference between groups was statistically significant (P = 0.014). There was no decrease in visual acuity attributable to complications of CXL in the treated eyes. At 1-year, the keratometry in 3 (12%) treated eyes increased by more than 0.50 D and were considered cases of failed treatment.
  
  
  CONCLUSIONS
  Preliminary and 1-year results indicate CXL can halt the progression of KCN in most cases without causing serious complications.
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Seyedian
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Aliakbari
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Miraftab
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Hashemi
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Asgari
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Khabazkhoob
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011184:Postoperative Period; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D017211:Treatment Failure; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: Collagen Cross-Linking; Keratoconus; Randomized Controlled Clinical Trial