ESCRS - PO675 - Long-Term Tomographic, Refractive, And Visual Analysis Of Keratoconus Eyes With Extreme Corneal Flattening After Corneal Crosslinking

Long-Term Tomographic, Refractive, And Visual Analysis Of Keratoconus Eyes With Extreme Corneal Flattening After Corneal Crosslinking

Published 2024 - 42nd Congress of the ESCRS

Reference: PO675 | Type: Free paper | DOI: 10.82333/fpmb-rq15

Authors: Maria A. Henriquez 1 , Ignacia Zenteno 1 , Rolando Rojas 1 , Jose Chauca 2 , Luis Izquierdo Jr.* 3

1Research Departament,Oftalmosalud Institute of Eye,Lima,Peru, 2Research Departament,Oftalmosalud Institute of Eye,Lima,Peru;Departament of Statistics, Demography, Humanities and Social Sciences,Universidad Peruana Cayetano Heredia,Lima,Peru, 3Research Departament,Oftalmosalud Institute of Eye,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru

Purpose

Purpose: To evaluate the long-term tomographic, refractive, and visual characteristics of eyes with extreme corneal flattening after corneal crosslinking (CXL) for progressive keratoconus (KC).

Setting

Oftalmosalud Institute of Eyes, Lima, Peru.

Methods

A Retrospective case-series study included eyes that underwent corneal CXL with epithelial removal between June 2006 and March 2017 and had extreme keratometric flattening (greater than 5 Diopters [D]) and a minimum follow-up of 5 years. Visual, tomographic, pachymetric, and refractive characteristics were evaluated. Corneal densitometry values were registered at last postoperative follow-up.   

Results

Mean follow-up time was 8.29 ± 2.75 years (range 5-13 years). 16 eyes were included in the study. Mean maximum keratometric (Kmax) flattening was 6.74D ± 3.56D (p <.001). According to Kmax there was a ‘progressive-flattening’ in 56.2% (9/16) of the eyes and extreme flattening followed by keratometric stabilization in 18.7% (3/16). 37.5% (6/16) presented an improvement of one or more lines of CDVA, while 31.25% (5/16) of the eyes showed a worsening of CDVA. Mean preoperative and last postoperative follow-up visit spherical equivalent was -3.92 ± 3.24 D and -1.46 ± 3.00 D, respectively (p = 0.002). At the last postoperative follow-up 31.2% (5/16) were on scleral lens, and 12.5% (2/16) had an indication for deep anterior lamellar keratoplasty

Conclusions

Extreme post-CXL keratometric flattening may be associated with improved, maintained, or worsted CDVA. Keratometric behavior is unpredictable; most cases experience progressive flattening over the years. Extreme flattening cases may require corneal transplantation for visual rehabilitation.