Official ESCRS | European Society of Cataract & Refractive Surgeons


Treatment outcomes data in keratoconus from routine clinical practice collected via the Save Sight Keratoconus Registry

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Session Details

Session Title: Keratoconus

Session Date/Time: Monday 16/09/2019 | 14:00-16:00

Paper Time: 14:18

Venue: Free Paper Forum: Podium 2

First Author: : S.Watson AUSTRALIA

Co Author(s): :    A. Ferdi   V. Nguyen   M. Abbondanza   F. Arnalich Montiel   M. Garcia   Y. Kerdraon              

Abstract Details


To report the use of a registry to collect high quality outcomes data, including 12-month outcomes data following cross-linking, in patients with keratoconus from routine clinical practice across Australia, New Zealand and Europe.


Ophthalmology practices across Australia, New Zealand and Europe.


A web-based registry tool was designed to collect data from patients with keratoconus attending ophthalmic practices across Australia, New Zealand, and Europe. Data was entered at the initial visit and then follow up visits. Index visit characteristics, such as visual acuity (VA, in Logarithm of the Minimal Angle of Resolution [logMAR] letters), maximum keratometry (Kmax), pachymetry, as well as treatment parameters (epithelial status, riboflavin type, UV duration), outcomes (VA, Kmax, pachymetry) and ocular adverse events were recorded in the prospectively designed electronic database. Index visit characteristics associated with the 12-month VA outcome were identified using mixed effects linear regression.


18,586 visits of 2,130 patients (3,936 eyes) from 60 sites with 1,461 cross-linking procedures were included. Mean change in VA in the 12-month cohort was 5.0 logMAR letters (95%CI: 3.7,6.3); Kmax -1.2D (-1.5,-0.9) and pachymetry -14.4 (-16.8,-11.9) microns; all significantly improved at 12-months and 3-years (all p<0.001). Epithelial-off treatment was performed in 1,948 cases; short UV-exposure (10min) in 1,199 eyes and long (30min) in 785. Adverse events in 219 eyes included clinically significant haze (n=291), microbial keratitis (14), persistent epithelial defect (18), progressive keratoconus (10), recurrent erosion (7), scarring (36), sterile infiltrates (14), steroid-response (1) and oedema (8).


Corneal cross-linking can stabilize visual acuity and corneal parameters when used in routine clinical practice, it may also improve vision in keratoconus. Adverse events however can compromise outcomes.

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