Long Term Corneal Flattening After Corneal Crosslinking In Patients With Progressive Keratoconus

Published 2023 - 41st Congress of the ESCRS

Reference: PP14.13 | Type: Free paper | DOI: 10.82333/b309-5q43

Authors: Maria A. Henriquez* ¹ , Lisett Perez ¹ , Gustavo Hernandez-Sahagun ¹ , Rolando Rojas ¹ , Doyle Stulting ² , Luis Izquierdo ¹

¹Research Department,Oftalmosalud Institute of Eyes,Lima,Peru, ²Stulting Research Center,Woolfson Eye Institute,Atlanta,United States

Purpose

To evaluate the long-term outcome of corneal crosslinking (CXL) in patients with progressive keratoconus (KC) and the incidence of an extreme corneal flattening effect.

Setting

Oftalmosalud Institute of Eyes, Lima, Peru

Methods

Retrospective cohort study. 45 eyes that underwent CXL with epithelial removal between June 2006 and September 2011 were examined 1 at least 10 years postoperatively. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and Scheimpflug (Pentacam) analysis. Progression was defined by an increase in steep keratometry (Ks) of 1.5D or greater between 2 examinations. Extreme flattening effect was defined as a decrease in K values equal or greater than 5 diopters(D).

Results

Mean follow-up time was 11 ± 1.07 years (range 10-13 years). There was a significant improvement on Ks, UCVA, CDVA and spherical equivalent at the last visit. The overall rate of progression was 2.22% (1/45). Extreme flattening was observed in 15.5% (7/45) of the eyes, and this was associated with a loss of CDVA in 4.44% (2/45) of the eyes. One eye with corneal flattening of 11.5 D lost 7 lines of CDVA and required corneal transplantation.

Conclusions

CXL is a safe and effective procedure to stop the progression of KC with a good overall long-term success rate. Extreme corneal flattening may be more common than commonly recognized, and severe corneal flattening associated with a decrease in CDVA may occur