To evaluate the changes in corneal keratometry (K) readings after corneal collagen cross- linking (CXL) using 20% alcohol in primary keratoconus and keratectasia after refractive surgery.

Twelve eyes of 10 patients with primary keratoconus and 3 eyes of 3 patients with keratectasia after refractive surgery were included in the present study. Best-corrected visual acuity (BCVA) and mean K, corneal astigmatism by corneal topography, and mean K, corneal astigmatism, and spherical equivalent (SE) by auto refractometer were evaluated at baseline, and 6 months postoperatively. Eight eyes of 7 patients were also evaluated 1 year postoperatively.

Mean BCVA improved from log MAR 0.66 ± 0.50 to log MAR 0.55 ± 0.58 ( p = 0.100) at 6 month after CXL. In corneal topography, mean K significantly decreased from 50.04 ± 5.88 D to 49.18 ± 6.15 D ( p = 0.019), and corneal astigmatism slightly decreased from 5.33 ± 4.47 D to 5.29 ± 4.88 D ( p = 0.755) at 6 months after CXL. According to the auto refractometer, mean K significantly decreased from 48.53 ± 5.94 D to 47.95 ± 5.79 D ( p = 0.038), corneal astigmatism significantly decreased from 3.95 ± 2.54 D to 3.52 ± 2.40 D ( p = 0.010), and SE significantly decreased from -6.25 ± 3.45 D to -5.40 ± 2.91 D ( p = 0.037) at 6 months after CXL. Significant mean K and corneal astigmatism decreases in topography were also observed at 1 year after CXL. Complications related to CXL were not observed.

CXL using 20% alcohol appears to be a safe and promising treatment modality with less corneal stromal damage in progressive primary keratoconus and keratectasia after refractive surgery.