Outcomes Of Collagen Crosslinking In Patients With Keratoconus And Secondary Limbal Stem Cell Deficiency
Published 2024 - 42nd Congress of the ESCRS
Reference: PO665 | Type: Free paper | DOI: 10.82333/2ym3-tr21
Authors: Eeshita Agarwal* 1 , Rashmi Deshmukh 2
1Cornea and anterior segment,LV Prasad Eye Institute,Hyderabad ,India, 2Cataract and refractive services ,LV Prasad Eye Institute,Hyderabad ,India;-,-,-,-;-,-,-,-
Purpose
To analyse the outcomes of collagen crosslinking (CXL) treatment in eyes with progressive keratoconus (KC) and with secondary limbal stem cell deficiency (LSCD) caused by vernal keratoconjunctivitis (VKC)
Setting
Retrospective observational study done in LV Prasad Eye institute, Hyderabad
Methods
Patients diagnosed with progressive KC and VKC having co-existent LSCD who underwent CXL from May 2016 to October 2023 were included in the study. Demographic details, clinical and corneal topography data was collected preoperatively, and at 1 months, 3 months, 6 months and 1 year. Details of the CXL procedure including the protocol used were noted. Complications were noted in the early post-operative period. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and topographic indices including flattest keratometry (K1), steepest keratometry (K2), mean keratometry (Km), maximum keratometry(Kmax) and thinnest corneal thickness (TCT) were noted at 1 year and compared with the preoperative data.
Results
11 eyes of 6 patients were included. Partial LSCD was in 10 eyes and 1 eye had total LSCD.10 eyes underwent epi-off CXL while transepithelial CXL in 1.LogMAR UCVA before CXL was 0.67 + 0.37 which improved to 0.65 ± 0.35 logMAR at 1 year post-CXL. Mean pre-CXL BCVA was 0.55 ± 0.42 while the post-CXL BCVA at 1 year was 0.42+/-0.26. Mean pre-CXL K1 and K2 were decreased from 52.97+ 5.72( med 53.7) to 50.16+/-4.93 (med 48.2) and 58.74 +3.73 (median 58.4) to 55.87+/-3.41 (med 54.9) after CXL, respectively. Pre-cxl Km was 55.57+/-4.76 (median 55.2) which decreased to post-cxl value of 52.84+4.01 ( med 51.3). Kmax reduced from 66.31+5.09 (med 67.3) pre-CXL to 63.6+4.16 (med 62) post-CXL. Of the 11 eyes, 2 eyes (18.1%) had PEDs and 1 needed AMG.
Conclusions
This study highlights the importance of optimising the ocular surface before CXL in such eyes. PEDs are expected in the early post-operative period. At one year, all the eyes showed topographic stability.