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First Author: K.Kránitz HUNGARY
Co Author(s): I. Kovács K. Miháltz G. László Sándor É. Juhász A. Gyenes Z. Zsolt Nagy
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To evaluate long term accuracy of different topography indices of Scheimpflug-camera in detecting therapeutic effect of corneal cross-linking therapy (CXL) in progressive keratoconus.
Department of Ophthalmology Semmelweis University, Budapest, Hungary
50 eyes of 25 patients with keratoconus were enrolled, CXL was performed in 25 progressive keratoconus eyes (CXL group) and 25 non-progressive fellow eyes served as control. Thinnest corneal thickness (ThCT), anterior keratometry (K1, K2) and keratoconus indices were measured with Scheimpflug-camera before and 12 to 25 months after CXL. Regression analysis was used to evaluate the influence of corneal thickness and follow-up time on flattening effect of CXL
At baseline, anterior steep keratometry values (K2) were significantly higher, while ThCT values were significantly lower in the CXL group (p=0.027 and p=0.034), parallel with significantly increased value of the following keratoconus indices: index of surface variance (ISV; p=0.013), index of vertical asymmetry (IVA; p=0.038) keratoconus index (KI; p=0.019), center keratoconus index (CKI; p=0.039), index of height asymmetry (IHA; p=0.037), index of height decentration (IHD; p=0.0016) and radius minimum (Rmin; p=0.008). After adjustment for corneal thickness and follow-up time CXL had significant flattening effect expressed by changes in Rmin (p<0.001), ISV (p=0.03), KI (p=0.006), CKI (p=0.03) and index of height asymmetry (IHA; p=0.026). ThCT had significant influence on changes of ISV (p=0.049), IVA (p=0.01) and CKI (p=0.03) values after CXL. Follow up time showed no significant influence in any models (p>0.05)
Majority of topographic indices indicate corneal flattening after CXL in the long term. However during their interpretation initial corneal thickness has to be taken into consideration except for KI and IHA. In a daily clinical practice measuring KI and IHA indices would be recommended as these parameters were not influenced by initial corneal thickness and were able to show corneal flattening after CXL treatment.