摘要：Background: To evaluate any change in tear indices and confocal microscopic findings aftercorneal collagen crosslinking (CXL) in patients with progressive keratoconus. Methods: Thirty?two consecutive eyes from 23 patients having progressive keratoconus wereenrolled in this prospective, interventional cohort study. The standard crosslinking surgery wasperformed for all patients. Visual, refractive, and topographic evaluations were done beforeand at 6 months after surgery. Tear function tests and confocal microscopic examination wereperformed before and at 1 month and 6 months after the procedure. Results: There was no significant change in Schirmer?1 test results and tear osmolarityat 1 month and 6 months after CXL. Using confocal microscopy, all eyes showed reducedor absent subepithelial nerve plexus. Differences in basal epithelial cell density, epithelialmean cell area, and keratocyte density in anterior and middle stroma and endothelial cellpleomorphism were all significant at 1 month and 6 months after CXL (P Significant improvement was noted in uncorrected visual acuity, best corrected visual acuity, flattest corneal meridian (K2), and maximum keratometry in Pentacam (Kmax) after 6 monthsof the procedure. Conclusions: While CXL would have no effect on tear indices and endothelial cell count, it cancause a significant reduction in subepithelial nerve plexus and significant alterations in epithelialcell density in the anterior and middle stroma.
