Purpose: The main aim of this study was to evaluate corneal keratometric and endothelial cell changes after a modified corneal collagen accelerated cross-linking with vitamin B2 (Riboflavin) for 10 minutes, and accelerated UVA irradiation, for the treatment of Keratoconus. Customized delivery of UVA radiation exposure limited to 18mw/cm2 instead of 30 mw/cm2 over 6 minutes.
Methods: Twenty keratoconus eyes, followed up for 6 months after epithelium-off accelerated CXL crosslinking with fixed 10 minutes riboflavin soaking and only 18 mw/cm2 ultraviolet exposure for 6min. Pentacam HR was used for measuring steep & flat anterior keratometry, Kmax and corneal thickness pre. & post operatively.  Visual & specular microscopic changes were studied before and 6 weeks after CXL for observing endothelial cell changes after the procedure.
Results: Keratometric values showed significant reduction in corneal steepening. Kmax showed a mean reduction of 3.754 D with a remarkable significance p Conclusion: CXL safety is recommended as it is becoming the standard treatment caption for progressive Keratoconus world wide. We strongly recommend that the irradiance level should be clearly minimized to the level which induces therapeutic goal and low toxic effects