Background: Corneal cross-linking is the most used strategy to treat keratoconus, aims to slow down even arresting the progression of the disease. Although collagen CXL is considered safe and effective procedure, CXL can cause endothelial failure, with significant corneal edema, and patients may require penetrating keratoplasty based on the extent of endothelial damage.
Objectives: To evaluate the corneal endothelial cell changes by Specular microscopy, after Cross-linking of the cornea in keratoconus cases, as a comparison of the Accelerated Protocol and the Standard Dresden Protocol.
Patients and Methods: This study is a prospective study, performed on twenty-two keratoconus-afflicted eyes of both sexes at ophthalmology Department, Faculty of Medicine, Menoufia University, in partnership with cornea and refractive units, Giza Research Institute of Ophthalmology, during the period from February 2023 to April 2024. Patients were divided into two groups as follows: Group (I) underwent accelerated protocol, and Group (II) underwent Standard Dresden protocol.
Results: The groups under study did not differ significantly regarding density of corneal endothelial cells, average area, coefficient of variation, hexagonal cells, and thickness of cornea (P>0.05).
Conclusion: Corneal CXL with Riboflavin and UV-A irradiation stops progression of KC in all eyes. The use of accelerated CXL had the same impact on corneal endothelium as conventional CXL.