Keratoconus Progression After Collagen Cross-Linking In A National Reference Center In Guatemala
Published 2025 - 43rd Congress of the ESCRS
Reference: PP02.12 | Type: Free paper | DOI: 10.82333/d5es-7e55
Authors: Avinoam Shye* 1 , Aya Wattad 1 , Igor Kaiserman 2 , Gur Munzer 3 , Tzachi Sela 3 , Michael Mimouni 4 , Eyal Cohen 5
1Ophthalmology,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel, 2Ophthalmology,Barzilai Medical Center,Ashkelon,Israel;Care-Vision Laser Center,Tel Aviv,Israel;Faculty of Health Sciences,Ben-Gurion University of the Negev,Beer Sheba,Israel, 3Care-Vision Laser Center,Tel Aviv,Israel, 4Ophthalmology,Rambam Health Care Campus,Haifa,Israel;Ruth and Bruce Rappaport Faculty of Medicine,Technion - Israel Institute of Technology,Haifa,Israel, 5Ophthalmology,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel;Care-Vision Laser Center,Tel Aviv,Israel;Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel
Purpose
To determine the rate of keratoconus progression after corneal collagen cross-linking in a national reference center. To stablish related factors to keratoconus progression.
Setting
Cornea and anterior segment clinic, Unidad Nacional de Oftalmología, Guatemala City, Central America
Methods
Patients diagnosed with keratoconus from January 2022 to December 2023 who underwent epi-off accelerated corneal collagen cross-linking (Peschke, Switzerland) and completed topographic evaluation with Pentacam® (Oculus, Germany) before 3, 6 y 12 months after the procedure were included. Demographic and clinical data associated with progression were recorded. Keratoconus progression was defined as any change in the ABCD (anterior sagittal curvature, posterior elevation, central corneal thickness and distance visual acuity) Belin classification system and change in Maximum keratometry (Kmax) >1 diopter (D). Statistical significance set at 0.05, variance analysis and chi square tests performed
Results
Among the 85 eyes, 14 exhibited progression according to the ABCD criteria, resulting in a progression rate of 16%. In contrast, 23 patients showed progression based on Kmax measurements, leading to a higher progression rate of 27%. These results highlight the variability in progression rates depending on the assessment criteria used.
Conclusions
Corneal crosslinking demonstrates significant efficacy in halting the progression of keratoconus in the majority of patients. However, a subset of patients continues to progress, (16-27%) emphasizing the need for ongoing monitoring and individualized treatment strategies. The findings suggest that certain factors, such as the presence of associated pathologies, might influence the likelihood of post-cross-linking progression, although larger studies are needed to confirm these associations Definition of progression in Keratoconus still a topic of debate.