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First Author: J.Salgado-Borges PORTUGAL
Co Author(s): T. Painhas F. Gomes-Rodrigues F. Esteves C. Costa-Ferreira
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The aim of this study is to assess 1 year outcome of corneal collagen cross-linking (CXL) using ultraviolet-A light in eyes with progressive keratoconus (QC).
Centro Hospitalar de Entre Douro e Vouga - Santa Maria da Feira
Fifteen eyes of fifteen patients (mean age 25,25 +/- 6,21) with progressive keratoconus were included in this prospective study. Eight eyes completed 1 year of follow-up and 7 eyes had a 6-month follow-up. We accessed uncorrected (UDVA) and best corrected (CDVA) distance visual acuity, spherical equivalent (SE), manifest cylinder (MS), corneal topography, pachymetry and corneal compensated intraocular pressure IOPcc as well as corneal histerese(CH) and corneal resistance factor (CRF) preoperatively and at several examinations postoperatively. All patients were submitted to corneal CXL with riboflavin and ultraviolet light A according to the protocol of Dresden.
The preoperative values were compared with postoperative values at 3, 6 and when applied, at 12 month of follow-up. Progression of QC stopped in all patients. The CDVA improved from 0.56 +/- 0.18 to 0.60 +/- 0.18 at 3 months, reaching a statistically significant difference (p <0,05) at 6 and 12 months with CDVA of 0.69 and 0.72 respectively. The UDVA increased at 3, 6 and 12 months without reaching statistical significance at any point. Four eyes mantained the preoperative CDVA, nine eyes gained one or more lines and two eyes lost one line. At 3, 6 and 12 months, SE and MS had improved less than 1D comparing to the baseline but without reaching statistical significance. The maximum keratometry value (K max) decreased from the baseline 51.15 D to 49.63D at 6 months and remain stable at 12 months (statistical significance difference at 6 and 12 months) at . The pachymetry after procedure suffered significant decrease at 3 months with recovery at 6 and 12 months, but without reaching baseline. There was an increase in CRF, IOPcc at 6 months compared to preoperative values, whereas the CH values increased without reaching statistical significance.
The corneal collagen CXL is a promising treatment for progressive QC. As it changes the biomechanical properties of the cornea, it is able to delay the progression of the disease and, in some cases even enhance the refractive, topographic and visual parameters. Our results show a stabilization and even an improvement of QC after collagen CXL, being necessary, however, necessary to observe the results in a longer term.