AIM: To observe the safety and efficacy of epithelium-off corneal collagen cross-linking(CXL)combined with rigid gas permeable contact lens(RGPCL)in treatment of progressive keratoconus.

METHODS: From January 2015 to January 2017, 51 cases(51 eyes)of patients diagnosed with keratoconus and epithelium-off CXL treatment at the Eye Hospital of Nanjing Medical University were collected. The patients were divided into two groups according to whether they wore RGPCL or not after treatment. Group A: 30 eyes, epithelium-off CXL was removed and wear a framed mirror after treatment; Group B: 21 eyes, epithelium-off CXL was removed and RGPCL was worn after the condition was stable. Observed the best corrected visual acuity(BCVA), spherical equivalent(SE), minimum keratometry of the anterior corneal surface(K1), maximum keratometry of the anterior corneal surface(K2), mean keratometry(Km), maximal keratometry(Kmax), corneal vertex thickness, thinnest corneal thickness(TCT)before and 12mo after treatment.

RESULTS: No statistically significant differences were found before the therapy between the two groups in BCVA, SE, K1, K2, Km, Kmax, corneal vertex thickness, and TCT between the two groups(P>0.05). 12mo after treatment, BCVA in group B was significantly higher than that in group A(0.11±0.03 vs 0.26±0.16), the corneal vertex thickness of group B was lower than that of group A(431.8±14.41μm vs 461.38±32.68μm)(P<0.05), there was no significant difference in other parameters between the two groups.

CONCLUSION: Epithelium-off CXL can effectively delay or control the progression of keratoconus. Wearing RGPCL after treatment can effectively improve BCVA.