To compare newly proposed accelerated corneal cross-linking (CXL) versus conventional procedure for management of keratoconus.

166 consecutive keratoconic patients who were allocated to 2 groups to receive either accelerated CXL or conventional CXL were studied. 83 patients were allocated to each group. All patients were evaluated preoperatively and postoperatively at 1st week, and 1st, 3rd, 6th, and 12th month. In each exam session each patient underwent refraction, visual acuity examination, specular microscopy, corneal topography, corneal haze, and confocal microscopy.

UDVA and CDVA were significantly improved in both groups. Sphere, cylinder, spherical equivalent, and maximum keratometry significantly decreased in both groups. The difference was not significant between groups in neither parameter. Endothelial cell density had no significant change in either group. Percentage of hexagonality and coefficient of variation deteriorated during one month post operative and improved afterwards in both groups. Corneal haze increased significantly one month after operation and reduced after that in both groups. Early reduction in keratocyte density and sub-bowman nerve plexus occurred in both groups. It returned to normal value more rapidly in accelerated CXL.

Accelerated CXL procedure was as effective as conventional CXL to stabilize progression of keratoconus. Conventional UVX seems to have longer effect on corneal keratocyte density.