ESCRS - PO0607 - Evaluation Of Clinical Profile And Risk Factors Necessitating Repeat Collagen Cross Linking In Keratoconus

Evaluation Of Clinical Profile And Risk Factors Necessitating Repeat Collagen Cross Linking In Keratoconus

Published 2023 - 41st Congress of the ESCRS

Reference: PO0607 | Type: Free paper | DOI: 10.82333/p0zt-2n56

Authors: Aniruddh Heroor* 1 , Rashmi Deshmukh 2

1Resident,LV Prasad Eye Institute,Hyderabad,India, 2Cataract and Refractive Services,LV Prasad Eye Institute,Hyderabad,India

Purpose

Progression of keratoconus is treated by collagen crosslinking (CXL). However, certain risk factors lead to the failure of the procedure and the need for repeat CXL. There are very few reports describing such case scenarios.  We aim to elucidate the clinical characteristics of patients with progression after primary CXL in keratoconus requiring repeat CXL, risk factors predisposing to progression and outcomes after repeat CXL.

Setting

Tertiary Care Eye Centre in South India

Methods

Data of 18 eyes of 17 patients who underwent repeat CXL was collected retrospectively from the electronic medical records system and reviewed. All patients underwent corneal tomography before and after the repeated CXL. Progression was noted as an increase in Kmax of 1 dioptre(D) in 1 year or 0.5 D in 6 months. Demographic details ,common risk factors for progression, duration between primary and repeat CXL, topographic data and data pertaining to CXL protocols used were noted. The data obtained was analysed using the R-4.2.2 software.

Results

The mean age of patients was 17.6±5.8 years.Males(12) were twice as common as females(6).Young age was found to be the most frequent risk factor(12 eyes),allergic eye disease was seen in 6 eyes,habitual eye rubbing was present in 5 eyes,and 2 eyes had a history of contact lens use. Mean Kmax value before the first CXL was available in 14 eyes and was 61.6 ±7.5D while the pre operative mean Kmax before repeat CXL was available for all 18 eyes and was 65.8±4.6D. The mean progression was 2.98±2D over 6 months-2 years.Mean duration between the primary and repeat CXL was 46.1±33.8 months(6-120 months).Over a mean follow up of 28.88±30.2 months(1-120 months) 14 eyes were stable while 4 eyes are still under follow up.

Conclusions

We describe the clinical and topographic characteristics of patients with CXL in keratoconus that is likely to cause progression necessitating a repeat CXL procedure. We also present the results of repeat CXL in the largest series of such eyes.