Evaluation of Corneal Endothelial Changes Using Specular Microscope before and after Collagen Cross Linking for the Treatment of Keratoconus

Abstract
Background: Keratoconus is a non-inflammatory condition in which the center of the cornea progressively thins and develops a cone-shaped bulge that blurs and distorts vision. A normal cornea is round, with even curvature like that of a sphere. But with keratoconus, the curvature is irregular and too steep, like the narrow end of an egg. Any change in the shape of the cornea changes the way light passes through the eye, and results in a change in vision. When the cornea is too steep, light converges in front of the retina, causing nearsight-edness.
Aim of the Work: The purpose of this work is to evaluate the corneal endothelial changes following corneal collagen cross linking (CXL) for the treatment of progressive kerato-conus using corneal specular microscopy.
Patient and Methods: This study was a prospective, non-randomised controlled interventional case series. Patients from age 18 to 40 years old diagnosed with progressive keratoconus tested to detect if there is change in corneal endothelium after cross linking or not.
Results: Our study was done on 40 eyes in patient age from 18-40 years old. It showed that there were statistically non significant changes in corneal endothelial counts include central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV%), Hexagonal cells %, after cross linking procedure in keratoconic patients during one month follow-up.
Conclusion: Our results demonstrated no changes in human corneal endothelium following UVA/riboflavin CXL.