ESCRS - PO483 - 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 2025 - 43rd Congress of the ESCRS

Reference: PO483 | Type: Free paper | DOI: 10.82333/mfgk-3t84

Authors: Khan Ahmad Muhammad* 1

1Ophthalmology,Aier Eye Hospital, Group Co., Ltd, Changsha, South Furong Rd, Hunan, China1,Changsha,China

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

Research Department at Ofttalmosalud, Instituto de Ojos, Lima, Peru.

Methods

A Retrospective observational 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.

Results

Mean follow-up time was 7.6 ± 2.6 years (range 5-13 years). Fifteen eyes were included in the study. Mean maximum keratometric (Kmax) flattening was -7.58 D ± 2.63D (range 5.0 D - 12.2 D, [p < 0.001]). 56.25% (9/15) of the eyes experienced progressive flattening over the years. 40% (6/15) presented an improvement of one or more lines of corrected distance visual acuity (CDVA), and 26.6% (5/16) of the eyes showed a worsening of CDVA.  Logistic regression analysis revealed that postoperative Kmax flattening greater than 2D at the first year postop (OR 17.7, 95% CI 4.4 to 71.2) and preoperative Kmax greater than 55D (OR 8.8, 95% CI 2.7 to 28.3) were significant risk factors for extreme postop keratometric flattening

Conclusions

Progressive extreme corneal flattening when accompanied with a decrease of CDVA was a late complication of CXL that may have required corneal transplantation for visual rehabilitation. Preoperative steeper corneas and keratometric flattening greater than 2D at the first year postoperative period were risk factors associated with long-term extreme postoperative corneal flattening.