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Accelerated corneal collagen cross-linking for keratoconus: one year results

Poster Details

First Author: P.Gupta INDIA

Co Author(s):    J. Reddy   V. Bhandari   K. Siddharthan        

Abstract Details



Purpose:

To evaluate the effectiveness and safety of accelerated corneal collagen crosslinking (C3R) in patients of keratoconus.

Setting:

Sankara Eye Center, Coimbatore, India.

Methods:

In this prospective study 90 eyes of 66 patients were included. Inclusion criterion was cases of keratoconus with minimum corneal thickness of 375 ┬Ám. Exclusion criteria were concurrent corneal infection and pregnant or lactating women. The procedure was performed using topical anesthesia of proparacaine 0.5% eyedrops. In children conscious sedation was given if required. Corneal epithelium was removed over 6-8 mm zone depending on location of cone on corneal topography. Riboflavin drops were applied at one minute intervals for a total induction period of 8-10 minutes followed by UVA irradiation with a power of 30 mW/cm2 and duration of 3 to 3.4 minutes to deliver total energy of 5.4 to 6.6 J/cm2. After treatment bandage contact lens was applied until complete epithelium healing. Post operatively antibiotic and steroid eye drops were used for 2 weeks.

Results:

Follow up was for 12 months. Age group was 11 to 38 years. Results were evaluated in terms of best corrected visual acuity ( BCVA ), refraction, topography and endothelial cell count (ECC). Mean BCVA before intervention was 0.34 logmar units and it improved to 0.21 logmar units after intervention. No eye lost any lines of BCVA. Mean improvement in spherical equivalent refraction was 0.80 diopters. Mean steepest keratometry reduced from value of 52.36 diopters to 51.68 diopters. Mean flattest keratometry reduced from value of 47.28 diopters to 46.52 diopters after the procedure. Mean ECC before intervention was 2684 and it changed to 2654 after the procedure.

Conclusions:

Results in present study show that accelerated C3R can halt the progression of keratoconus with some improvement in BCVA. In accelerated C3R post operative stromal haze is minimal. Moreover compared to conventional C3R which takes around 1 hour , accelerated C3R is much faster as it takes only 10-15 mins for the whole procedure. With these advantages accelerated C3R has the potential to become preferred crosslinking modality in the management of keratoconus. FINANCIAL INTEREST: NONE

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