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Corneal cross-linking for keratoconus-relapse after penetrating keratoplasty

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Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 10/10/2017 | 14:00-16:30

Paper Time: 15:10

Venue: Room 4.6

First Author: : I.Barequet ISRAEL

Co Author(s): :    A. Abd Elkader   I. Gazit   N. Avni-Zauberman   Y. Berger           

Abstract Details


Keratoconus is a progressive ectatic disease causing irregular astigmatism that may severely affect vision. In severe cases keratoconus patients undergo keratoplasty for visual rehabilitation. In rare cases keratoconus may recur in patients with corneal graft, resulting in visual deterioration and has a detrimental effect on the success of corneal grafts. The aim of our study was to evaluate the safety and efficacy of Corneal Cross-Linking (CXL) procedure in eyes with corneal grafts and keratoconus relapse.


Goldscheger Eye Institute, Sheba Medical Center, Tel Aviv University Sackler Faculty of Medicine


We reviewed the data of 4 eyes from 3 keratoconus patients who went penetrating keratoplasty and showed a late relapse of keratoconus associated with vision deterioration and appearance of novel irregular astigmatism and topographic inferior steepening, despite clear grafts and intact graft-host junctions. CXL was performed using the Dresden protocol. Data was collected on maximum keratometry (Kmax), astigmatism and thinnest corneal thickness according to topography, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA) were studied preoperatively and 1 year postoperatively.


Preoperative CDVA were 0.62 ± 0.1 (decimals) one month before the CXL procedure. CDVA significantly improved to 0.71  ± 0.15 (decimals) one year after CXL. Preoperative Kmax and astigmatism were 51.98 ± 11.6 diopter (D) and -8.22  ± 3.2 D, respectively. One year after the CXL procedure, Kmax and astigmatism were 51.07 ± 7.5 and -7.5  ± 2 D, respectively. The thinnest corneal thickness was 409.75 ± 20 u and 404 ± 16 u before and after the CXL, respectively. No intra- or postoperative complications were noted after the procedures.


The results of our series reviewing treatment of keratoconus relapse in corneal grafts - indicates that CXL is a safe and effective procedure in these unique eyes. CXL should be considered immediately when relapse of keratoconus occurs after keratoplasty.

Financial Disclosure:


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