ESCRS - PO147 - Progressive Keratoconus In Patients Older Than 48 Years

Progressive Keratoconus In Patients Older Than 48 Years

Published 2024 - 42nd Congress of the ESCRS

Reference: PO147 | Type: Case Report | DOI: 10.82333/2xz9-s508

Authors: Léonard Kollros* 1 , Emilio A. Torres-Netto 2 , Carmen Rodriguez-Villalobos 3 , Nikki L. Hafezi 3 , Mark Hillen 3 , Nan-Ji Lu 3 , Farhad Hafezi 4

1ELZA Institute,Dietikon,Switzerland;University of Applied Sciences and Arts Northwestern Switzerland (FHNW),Olten,Switzerland, 2ELZA Institute,Dietikon,Switzerland;University of Zurich,Zurich,Switzerland;University of Geneva,Geneva,Switzerland, 3ELZA Institute,Dietikon,Switzerland, 4ELZA Institute,Dietikon,Switzerland;University of Zurich,Zurich,Switzerland;University of Geneva,Geneva,Switzerland;NYU Langone Health,New York,United States;Wenzhou Medical University,Wenzhou,China

Purpose

To discuss the cases and treatment outcomes of patients with progressive keratoconus in aged 48 years and over, and the efficacy of corneal cross-linking (CXL) with riboflavin and ultraviolet-A light in arresting disease progression.

Setting

The case series was conducted at the ELZA Institute, Dietikon, Switzerland.

Report of case

A retrospective analysis was performed on 5 eyes from 4 patients, aged between 48 to 54 years, with documented progressive keratoconus. Corneal tomography was used for diagnosis and monitoring. The progression rate and response to CXL procedures were evaluated. Keratoconus progression was noted in older patients, with progression rates varying from 1.4 D over six months to 14.6 D over 14 months. CXL resulted in the stabilization of keratoconus in all cases, although one patient required a second CXL procedure to stabilize their cornea.

Conclusion/Take home message

Although keratoconus progression is less likely to occur in older individuals, compared with younger people, the probability of it occurring does not ever disappear. Regular screening with corneal tomography of patients with keratoconus and other corneal ectasias – even in those with prior stable keratoconus – remains essential in older patients. CXL remains an effective treatment to halt keratoconus progression in this age group and may require tailored protocols based on individual corneal properties.