One-Year Outcomes Of Cross-Linking In Thin Corneas With Keratoconus: A Save Sight Keratoconus Registry Study
Published 2023 - 41st Congress of the ESCRS
Reference: PP14.12 | Type: Free paper | DOI: 10.82333/x4xe-jf53
Authors: Himal Kandel 1 , Aanchal Gupta 2 , Laurence Sullivan* 3 , Richard Mills 4 , Adam Watson 5 , CJ Proxenos 6 , Vincent Daien 7 , Marco Abbondanza 8 , Stephanie L Watson 1
1Save Sight Institute,The University of Sydney,Sydney,Australia;Sydney Eye Hospital,Sydney,Australia, 2Adelaide Eye & Laser Centre,Adelaide,Australia;South Australian Institute of Ophthalmology,Adelaide,Australia, 3Bayside Eye Specialists,Melbourne,Australia, 4Ophthalmology,Flinders Medical Centre,Adelaide,Australia, 5Eye Institute,Auckland,New Zealand, 6Sydney Eye Hospital,Sydney,Australia, 7Ophthalmology,University Hospital Montpellier,Montpellier,France, 8Abbondanza Eye Centres,Rome and Milan,Italy
Purpose
The objective of this study was to determine the efficacy of corneal cross-linking in thin corneas (≤400µm).
Setting
A longitudinal, observational study was conducted using the prospectively designed Save Sight Keratoconus Registry database. Data from 18 clinical practices in Australia, New Zealand, France, and Italy were analysed.
Methods
Epithelium-off corneal cross-linking was performed in 167 eyes (mean ± SD visual acuity 54.9±22.2 logMAR letters, Kmax 62.9±10.1 D, K2 55.1±7.1 D, minimum corneal thickness [MCT] 385.5±32 µm) of 149 patients (mean age 27.2±10.2 years; female 28.9%) with thin corneas. Outcome measures included changes in visual acuity, corneal curvature, and MCT 12 months after the corneal cross-linking procedure. Paired t-test and proportion of eyes with gain or loss in outcomes were used to evaluate changes in outcomes between baseline and follow-up visits.
Results
The mean changes in visual acuity and keratometry (gain 1.1 [95% CI, -1 to 3.3] logMAR letters), Kmax (-0.2 [-1.1 to 0.7]D), K2 (0.1 [-0.4 to 0.5] D) were not statistically significant (p = 0.298, 0.629, and 0.821, respectively). Visual acuity improved by ≥10 logMAR letters in 17.4% eyes, remained stable in 72.7% eyes, and worsened by ≥10 logMAR letters in 9.9% eyes. Similarly, Kmax increased by ≥1 D in 26.6% eyes, was stable in 40.5% eyes and decreased by ≥1D in 32.9% eyes.
The mean reduction in MCT was -14 [95% CI, -20 to -8]µm (p < 0.001). The MCT increased by ≥20µm in 9% eyes, remained stable in 53.8%, and decreased by ≥20µm in 37.2% eyes.
Conclusions
This real-world observational study found that the corneal cross-linking improved or stabilised visual and keratometry outcomes in most cases with thin corneas. A significant reduction in mean MCT was observed at the 12-month follow-up compared to the baseline values.