The Role Of Cyclosporine And Trehalose In Preventing Keratoconus Progression: A Corneal Tomography Analysis
Published 2025 - 43rd Congress of the ESCRS
Reference: PO561 | Type: Free paper | DOI: 10.82333/4s7y-yj16
Authors: Kolbe Roche* 1 , Jordi Castellví 2 , Rachid Bouchikh 1 , David Roche 3 , Sebastian Videla 4 , Antoni Sabala 1
1Ophthalmology,Hospital Germans Trias i Pujol,Badalona,Spain, 2Optometry,Hospital Germans Trias i Pujol,Badalona,Spain, 3Faculty of Echonomics and Social Sciences,Universitat Internacional de Catalunya,Barcelona,Spain, 4Clincal Research Support Area,Hospital Germans Trias i Pujol,Badalona,Spain
Purpose
To evaluate the potential role of topical cyclosporine and trehalose in stabilizing early-stage keratoconus (Belin ABCD Stage 0 and Stage 1) by analyzing corneal tomography parameters and assessing their impact on disease progression.
Setting
This study was conducted at the Ankara Bilkent City Hospital, Department of Ophthalmology
Methods
A total of 32 patients (15 male, 17 female) with an average age of 26 years and no eye itching symptoms were included. Fifty-three eyes diagnosed with early-stage keratoconus (Belin ABCD Stage 0 and 1) were analyzed. Corneal topography parameters, including K1, K2, Kmean, Kmax, astigmatism, thinnest pachymetry, and spherical equivalents, were recorded at baseline and follow-up. Progression was defined as an increase in Kmax > 1.0 D or a decrease in thinnest corneal thickness > 30 μm. Eleven patients had prior cross-linking treatment in one eye. We assessed the stability of fellow eyes receiving topical cyclosporine and unpreserved trehalose (Thealoz Duo®️, Thea, France).
Results
Over the follow-up period, 5 of 53 eyes (9.4%) met the criteria for progression, whereas 48 eyes (90,5%) remained stable while receiving cyclosporine and trehalose. Of the 11 eyes that had previously undergone CXL, 80% of contralateral eyes remained stable with topical treatment. As a result, five eyes from three patients were classified as showing progression based on Kmax and thinnest location values (Kmax change > 1 D, thinnest location change > 30 microns). Notably, all 5 progressing eyes were from patients under 22 years of age. No significant adverse effects were reported with topical treatment.
Conclusions
These findings suggest that topical cyclosporine and trehalose may help stabilize early-stage keratoconus and reduce the need for CXL. The observed reduction in progression rates highlights the potential of these agents as adjunctive therapies in KC management. However, this treatment may be somewhat insufficient in patients under 22 years of age, as progression was more commonly observed in this group. Further studies with larger cohorts and longer follow-up durations are needed to confirm these results and establish standardized treatment protocols.