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Effect of Cross-Linking on Corneal Thickness in Patients With Corneal Edema

Purpose: To investigate the pachymetric changes of collagen cross-linking in corneas with edema because of endothelial dysfunction. Methods: Interventional case series included 25 eyes of 25 consecutive patients with corneal edema for at least 4 months related to Fuchs endothelial dystrophy, corneal graft failure, and postoperative bullous keratopathy. Central corneal thickness was measured preoperatively, 1, 3, and 6 months after the procedure by ultrasound pachymetry and optical coherence tomography. Results: Mean central corneal thickness measured by ultrasound pachymetry decreased after corneal cross-linking (mean ± SD): 712.0 ± 99.7, 618.3 ± 103.0, and 657.5 ± 114.8 for preoperative, 1-, and 3-month follow-up, respectively. Differences between preoperative value and 1- and 3-month follow-up values were statistically significant (P < 0.01). Similar results were found with the optical coherence tomography (mean ± SD): 777.3 ± 131.0, 711.6 ± 133.1, 746.4 ± 142.4, and 830.6 ± 198.7, for preoperative, 1-, 3-, and 6-month follow-up values, respectively. Fourteen patients (56%) developed new epithelial bullae after 3 months; 11 patients (44%) remained asymptomatic until their last visit. Conclusion: Corneal cross-linking showed to be a safe procedure and potential therapeutic alternative for the treatment of corneal edema.