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A multivariate analysis and statistical model for predicting visual acuity and keratometry one year after cross-linking for keratoconus

Session Details

Session Title: Special Cases

Session Date/Time: Friday 14/02/2014 | 08:30-10:00

Paper Time: 08:36

Venue: Kosovel Hall (Level -2)

First Author: : RobertWisse THE NETHERLANDS

Co Author(s): :    Daniël A Godefrooij   Nienke Soeters   Saskia M Imhof   Allegonda Van der Lelij     

Abstract Details


To investigate putative prognostic factors for predicting visual acuity and keratometry one year following corneal cross-linking (CXL) for treating keratoconus.


Utrecht Cornea Research Group, Department of Ophthalmology, University Medical Center Utrecht, The Netherlands.


This study included all consecutively treated keratoconus patients (102 eyes) in one academic treatment centre, with minimal one-year follow-up following CXL. Primary treatment outcomes were corrected distance visual acuity (logMAR CDVA) and maximum keratometry (Kmax). Univariable analyses were performed to determine correlations between baseline parameters and follow-up measurements. Correlating factors (P≤0.20) were then entered into a multivariable linear regression analysis, and a model for predicting CDVA and Kmax was created.


Atopic constitution, positive family history and smoking were not independent factors affecting CXL outcomes. Multivariable analysis identified cone eccentricity as a major factor for predicting Kmax outcome (ß-coefficient 0.709, P 0.02), whereas age, gender and baseline keratometry were not independent contributors. Post-treatment visual acuity could be predicted based on pre-treatment visual acuity (ß-coefficient -0.621, P <0.01, R2 0.45). Specifically, a low visual acuity predicts visual improvement. A prediction model for Kmax did not accurately estimate treatment outcomes (R2 0.15).


Our results confirm the role of cone eccentricity with respect to the improvement of corneal curvature following CXL. Visual acuity outcome can be predicted accurately based on pre-treatment VA. Age, gender and Kmax are debated as independent factors for predicting the outcome of treating keratoconus with CXL. FINANCIAL INTEREST: NONE