# Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus

## TL;DR

A clinical trial found that corneal cross-linking can help stop the progression of keratoconus, but results varied among patients.

## Contribution

This study provides the first randomized trial evidence supporting the efficacy of corneal cross-linking for keratoconus.

## Key findings

- Treated eyes showed a decrease in corneal refractive power, while controls showed an increase.
- The difference in progression between treatment and control groups was statistically significant.
- Some treated patients still progressed, and some untreated controls improved, indicating variable treatment response.

## Abstract

Corneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy.

The efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model.

A total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/−standard deviation) by 0.35 +/− 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/− 0.61 dioptres/year. This difference was statistically significant (p = 0.02).

Our data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not.

NCT00626717, Date of registration: February 20, 2008.