Purpose: Keratoconus (KC) is defined as a progressive, non-inflammatory corenal ectasia of unknown origin. Corneal collagen cross-linking (CXL) is a well-known therapeutic modality of KC. Impression cytology (IC) is a minimally invasive approach of assessing human ocular surface cells and is considered as the ‘gold standard' approach in terms of morphological assessment of cells.
Patients and methods: This study was a prospective follow up study conducted on 21 patients with progressive keratoconus attending to ophthalmic center, Mansoura University. The cases were subjected to history taking and comprehensive ocular examination. CXL was done for all patients using riboflavin and ultraviolet –A irradiation. All patients were followed up (one month, three months, six months) after CXL. Conjunctival-corneal impression cytology was done by cellulose filter paper before the surgery and during follow up.
Results: Regarding the cohesion power follow-up, it was found that baseline and immediately after CXL, 6 cases (28.6%) showed group of coherent cells and 15 cases (71.4%) showed separate individual cells. At one month follow up, 1case (4.8%) showed one large sheet of coherent cells, 19 cases (90.5%) showed group of cells and 1case (4.8%) showed separate individual cells, with statistically significant difference compared to the baseline values. At six months follow up, 16 cases (76.2%) showed one large sheet of coherent cells and 5 cases (23.8%) showed group of cells, with statistically significant difference compared to the baseline values.
Conclusion: The current study concluded that CXL decreases keratoconus progression. postsurgical parameters tracked a reproducible trend over 6 months.