Statsenko Yauhen, Smetanina Darya, Voitetskii Roman, Simiyu Gillian Lylian, Pazniak Mikalai, Likhorad Elena, Pazniak Aleh, Beliakouski Pavel, Abelski Dmitri, Ismail Fatima, Neidl-Van Gorkom Klaus, Ljubisavljevic Milos
Medical Imaging Platform, ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, United Arab Emirates.
Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
Front Med (Lausanne). 2025 Jun 4;12:1462653. doi: 10.3389/fmed.2025.1462653. eCollection 2025.
Structural outcomes of corneal collagen cross-linking (CXL) have not been thoroughly investigated. Clinical risk assessment would benefit from a reliable prognosis of postoperative minimal (MCT) and central corneal thickness (CCT).
The objective of this study was to find a combination of diagnostic modalities and measurements that reliably reflect CXL efficiency in terms of corneal thickness.
We retrospectively reviewed the medical histories of 107 patients (131 eyes) who underwent CXL. The dataset included preoperative examinations and follow-up results, which totalled 796 observations.
The postoperative changes in MCT are more pronounced, clinically relevant, and meaningful than in CCT. MCT should serve as the major clinical marker of corneal thinning after CXL. The cornea's potential to recover reduces in advanced keratoconus. A polynomial curve demonstrates the natural course of corneal remodeling. It includes thinning immediately after CXL and stabilization with partial recovery of corneal thickness over time. Baseline pachymetry data can adequately reflect the outcomes. Preoperative BAD and topographic indices correlate with the outcomes. Keratometry and refractometry data exhibit associations with postoperative corneal thickness. The models trained on a combination of top correlating features, clinical data, and time after intervention provide the most reliable prognosis.
Risk assessment is accurate with multimodal preoperative diagnostics. A stratification system should take into account findings in different diagnostic modalities.
角膜胶原交联（CXL）的结构结果尚未得到充分研究。术后最小角膜厚度（MCT）和中央角膜厚度（CCT）的可靠预后将有助于临床风险评估。
本研究的目的是找到一种诊断方法和测量的组合，以可靠地反映CXL在角膜厚度方面的效率。
我们回顾性分析了107例（131只眼）接受CXL治疗患者的病历。数据集包括术前检查和随访结果，共计796项观察。
术后MCT的变化比CCT更明显、更具临床相关性且更有意义。MCT应作为CXL后角膜变薄的主要临床指标。晚期圆锥角膜中角膜恢复的潜力降低。多项式曲线显示了角膜重塑的自然过程。它包括CXL后立即变薄以及随着时间推移角膜厚度部分恢复并稳定。基线测厚数据可以充分反映结果。术前最佳矫正视力（BAD）和地形图指数与结果相关。角膜曲率计和验光数据与术后角膜厚度有关。基于顶级相关特征、临床数据和干预后时间的组合训练的模型提供了最可靠的预后。
多模式术前诊断可准确进行风险评估。分层系统应考虑不同诊断模式的结果。
