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Collagen cross-linking (CXL) for progressive keratoconus: long-term results and the impact of cone location and magnitude

Poster Details

First Author: P.Padmanabhan INDIA

Co Author(s):    S. Rachapalle Reddi                    

Abstract Details


1. To study the long term changes in refractive, topographic and tomographic indices after minimum of 2 years following CXL for progressive keratoconus. 2. To analyse the impact of cone severity and location on those changes.


Department of Cornea & External Disease, Sankara Nethralaya, Medical Research Foundation, Chennai, India.


Patients who underwent CXL for progressive keratoconus were followed up for a minimum of 2 years. Their vision, refraction, topography (Tomey IV), tomography (Pentacam) were analysed at 3 months, 6 months and annually thereafter. Cones were labelled ‘mild-moderate’ (Average K less than 53D) or advanced (greater than 53D), their location labelled central (within 2mm dia) or paracentral (outside central 2mm). The changes in all parameters with respect to magnitude and location of the cone were analyzed.


A total of 207 eyes of 163 patients mean age 23.99+/-4.6 years, underwent CXL between 2006-2011. Mean followup was 3.48+/- 1.09years, (2-6.6years). There was significant improvement in CDVA by 0.06+/-0.02 logMAR(p=0.001), a flattening of 0.62+/-0.32D in Kmax (p=0.05), a reduction of 0.61+/-0.20D in topographic cylinder. Cone location and magnitude did not have a significant impact on the response to CXL. CXL also resulted in a significant thinning by 35.98+/-3.61µ at the thinnest point (p less than 0.001) 24 eyes (20.17%) showed an increase in KMax by greater than/equal to 1D at last followup. There was no clinical evidence of endothelial damage in any patient.


CXL was effective in achieving long term stabilization of keratoconus in majority of patients eligible for treatment, irrespective of severity of disease or location of cone.

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