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Long-term results and complications in keratoconus

Poster Details

First Author: S.Goel INDIA

Co Author(s):    S. Mukherjee   S. Patel   A. Shastri        

Abstract Details



Purpose:

Keratoconus is an asymmetric corneal ectatic disorder resulting in irregular astigmatism and deterioration of vision. This is a prospective, clinical study of the outcome of corneal cross-linking on progressive keratoconus, Visual and refractive assessments, topographic and pachymetric analyses done at 1, 3, 6 and 12 months of follow up.

Setting:

Anand Eye Hospital, Jaipur, Rajasthan

Methods:

Involving 35 eyes of 23 subjects with progressive keratoconus.Surgical protocol used for cross linking followed was according to the standard protocol (Dresden) using Riboflavin 0.1% -UVA irradiation. UCVA, BCVA, manifest refraction, spherical equivalent, topography, pachymetry using AS-OCT. All patients were reviewed postoperatively on day 1, day 3, 1, 3, 6 & 12 months respectively.

Results:

Significant decrease in the mean maximum keratometry values. The thinnest point pachymetry in the treated eyes was consistently lower than pre-operative values over the entire follow up period though stabilizing after 6 months. Keratoconus Index ( KI) showed significant decrease after 12 months of cross linking suggesting flattening of the cone post crosslinking. Continued steepening of the keratometric values was noted in 2 of treated eyes at 12 months post-operatively hence showing disease progression and loss of Snellen lines.The possible complications of crosslinking include pain and sensitivity to bright light in the first few days, transient or persistent corneal stromal haze, progression of disease, and rarely infectious keratitis including bacterial, Acanthamoeba, and viral herpetic infections.In this study,the failure 4/35 eyes showed continued progression, progressed by mean 1.05 ± 1.04 D. To conclude, corneal collagen crosslinking appears to be a promising procedure for treating progressive keratoconus with a few reported side effects. Nevertheless, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement, use of topical corticosteroids, and application of a soft contact lens and hence needs to be appropriately counselled.

Conclusions:

Corneal collagen crosslinking appears to be a promising procedure for treating progressive keratoconus with a few reported side effects. Nevertheless, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement, use of topical corticosteroids, and application of a soft contact lens and hence needs to be appropriately counselled. FINANCIAL INTEREST: NONE

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