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Abstract This study showed that 6 months after CXL, the changes in the visual acuities, refraction, corneal bio-metric properties, and topography did not differ statistically significantly between standard CXL(3 mW/cm2, 30 minutes) and accelerated CXL(18 mW/cm2, 5 minutes) and that the 2 methods showed similar safety, efficacy, and predictability. The CCT decreased less with the accelerated method than with standard CXL but both methods arrested the progression of keratoconus similarly. This study showed asignificant improvement in visual acuity and refractive results in patients have done by the (epi–off ) method more than patients have done by (epi – on) method . These outcomes provide an indication of efficacy and safety of the (epi_off) method either standard or accelerated cross linking for treatment of keratoconus , and the rule of (epi-on) method in treatment of progressive keratoconus with thin cornea as it was safe and seemed to be moderately effective in keratoconic eyes with ultra thin corneas. |