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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objectives To compare endothelial cell density (CD) and morphology in the peripheral cornea before and after corneal cross-linking (CXL). Background Corneal CXL has been acknowledged as an effective method for halting the progression of keratoconus by photosensitization of riboflavin activated by ultraviolet A. For this surgical indication, it is usually recommended that the preoperative corneal thickness is at least 400 μm to prevent corneal endothelial cell damage caused by ultraviolet A irradiation. It has been reported that even 5 years after CXL, the endothelial CD did not change significantly at any postoperative interval. Patients and methods This study evaluated 40 eyes of 20 patients who were treated with standard CXL for progressive keratoconus. Preoperatively and 6 months postoperatively, we compared the corneal endothelial CD, the coefficient of variation in cell size, and the percentage of hexagonal cells, in the peripheral regions of the cornea, using a noncontact specular microscope. Results There was not any significant change in endothelial cell count particularly at 3 and 6 months post-CXL. In addition, the coefficient of variance was also statistically significantly higher at 3 and 6 months postoperatively than the pre-CXL value. There was a slight change in the percentage of hexagonal cells. Conclusion The use of accelerated CXL (10 mW/cm2 for 9 min) has a transient negative impact on endothelial CD and/or endothelial morphology.

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