Outcome Of Corneal Collagen Cross-Linking For Keratoconus In Down Syndrome Patients
Published 2023 - 41st Congress of the ESCRS
Reference: PP14.16 | Type: Free paper | DOI: 10.82333/t4r2-vg66
Authors: Denise Wajnsztajn* 1 , Sara Sánchez-Tabernero 2 , Frank Larkin 2
1Ophthalmology,Hadassah Medical Center - Hebrew University Hospital,Jerusalem,Israel, 2Ophthalmology,Moorfields Eye Hospital - NHS Foundation Trust,London,United Kingdom
Purpose
To report the outcome of corneal collagen cross-linking (CXL) for progressive keratoconus (KC) in Down syndrome (DS) patients.
Setting
A tertiary centre in the United Kingdom.
Methods
Retrospective review of DS patients who had CXL for KC in a single center with minimum follow-up of 12 months. Main outcomes were corrected distance visual acuity (CDVA, LogMAR), mean keratometry in the topographic steep meridian (K2) and maximum (Kmax) keratometry. CXL was performed with riboflavin 0.1% and high-fluence pulsed UVA (30mW/cm2 for total 4 minutes, with total energy 7.2 J/cm2).
Results
19 eyes (15 patients) with mean age 24.3 ± 5.9 (range 15-34) years had CXL. KC was too advanced for CXL in 5 contralateral eyes on account of corneal stromal thinning. Ocular comorbidity prior to CXL was frequent. There was a high rate of health disorders associated with general anaesthesia risk, in particular congenital cardiac disease (60%). Compared to baseline mean values, highest values of K2 and Kmax were found at five years post-CXL, at which time both K2 and Kmax had increased by mean 1.2 dioptres. Mean CDVA improved throughout the study period; at 5 years only one patient (20%) had lost 2 lines of Snellen visual acuity. There were no complications other than a steroid-responsive sterile infiltrate in one eye.
Conclusions
CXL appears safe and effective in stabilizing progression in KC in Down syndrome up to five years.