Crosslinking Versus Observation In Fellow Eyes Of Keratoconus Patients With One Crosslinked Eye
Published 2022 - 40th Congress of the ESCRS
Reference: FPM10.08 | Type: Free paper | DOI: 10.82333/1e7p-1t81
Authors: Uri Soiberman* 1 , Gavin Li 1 , Laura Di Meglio 1 , Jiangxia Wang 1 , Fasika Woreta 1 , Kraig S Bower 1 , Vishal Jhanji 2 , Divya Srikumaran 1
1Wilmer Eye Institute, Johns Hopkins Medicine,Baltimore,United States, 2UPMC Eye Center, University of Pittsburgh School of Medicine,Pittsburgh,United States
Purpose
To evaluate whether unilateral crosslinking (CXL) and conservative follow-up of the fellow eye is an acceptable management strategy in patients with keratoconus (KC).
Setting
Methods
Seventy-nine fellow eyes of KC subjects that initially underwent unilateral CXL were included. Thirty fellow eyes ultimately received CXL (group 1) whereas 49 fellow eyes were followed (group 2). Best spectacle corrected visual acuity and corneal tomographic parameters were collected in all eyes preoperatively and at the last follow-up.
Results
Subjects who received CXL in the fellow eye (group 1) were younger than subjects who did not (group 2, p=0.026). Group 1 eyes had higher baseline K1 (p=0.026), K2 (p=0.006), Km (p=0.01), and Kmax (p=0.002) compared to group 2 eyes. Amongst the 49 naïve fellow eyes (group 2), 19 eyes showed evidence of progression. Progressing naïve eyes had higher baseline K1, K2, Km, and Kmax (p<0.01); progressors also had thinner pachymetry at the pupil, apex, and thinnest point (p<0.01). Baseline values of K1≥43.5 Diopter (D), K2>45.1D, Km>44.3D, Kmax>47.9D, astigmatism>1.4D, pachymetry at the pupil<475µm, and thinnest pachymetry<478µm were tentative predictors of progression in the naïve fellow eye.
Conclusions