The 1-Year Outcomes Of Cross Linking In Keratoconic Patients At Singleton Hospital In Wales

Introduction: Untreated progressive keratoconus has the potential to cause significant morbidity. Collagen cross linking is the most effective method of halting disease progression. Our centre in Swansea is the first nurse led cross linking programme in Wales.

Aim: to determine the 1-year outcomes of cross linking in keratoconic patients.

Singleton Hospital, Swansea, Wales

Method: a retrospective audit was carried out at our single centre in Swansea. Primary outcomes measures included: best corrected visual acuity (BCVA), K1, K2, Kmax and central corneal thickness at baseline, 10-weeks and at 1-year. Safety data was also collected.

Results: initially between April 2021 and April 2023 n=60 eyes (of 45 patients) underwent cross linking treatment. These patients were followed up at 10-weeks post treatment. The 1-year follow up data included n=30 eyes. The mean age of patients included was 26 years (range 16-37 years). Data was compared between baseline and 10-weeks post treatment and baseline to 1-year post treatment. There was a statistically significant difference between baseline K1 and both 10-week K1 (p=0.049) and 1-year K1 (p=0.025). For all other parameters (BCVA, K2, Kmax and CCT) there were no statistically significant differences between any of the time point comparisons. Nil adverse effects were noted in any patients.

Conclusions: the only parameter that showed a statistically significant change over time was K1. K1 appears to flatten from baseline to 10-weeks and then remains relatively stable from 10-weeks to 1-year. Cross linking is effective at stabilising keratoconus.