Background: Long-term CXL outcomes in keratoconus require extended follow-up data. Methods: Retrospective analysis of 560 keratoconus eyes (360 patients) undergoing accelerated CXL (9mW/cm² for 10 minutes) with 5-year follow-up. Results: Flattening of maximum keratometry in 74.1% of eyes (mean -1.8D). Progression halted in 89.3%. CDVA improved by ≥1 line in 58.2%. Contact lens tolerance improved significantly. Complications: corneal haze in 12.6% (mostly transient). Conclusion: Accelerated CXL demonstrates durable halting of keratoconus progression with visual improvement in majority of patients at 5 years.
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