Keratoconus Progression After Corneal Cross-Linking in Eyes With Preoperative Maximum Keratometry Values of 58 Diopters and Steeper.

Kuechler, Samuel J; Tappeiner, Christoph; Epstein, Dan; Frueh, Beatrice E (2018). Keratoconus Progression After Corneal Cross-Linking in Eyes With Preoperative Maximum Keratometry Values of 58 Diopters and Steeper. Cornea, 37(11), pp. 1444-1448. Lippincott Williams & Wilkins 10.1097/ICO.0000000000001736

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PURPOSE

To evaluate the effectiveness of cross-linking (CXL) in treating keratoconus eyes with Kmax values ≥58.0 D.

METHODS

Retrospective analysis of outcomes of standard Dresden epi-off CXL in progressive keratoconus with preoperative Kmax ≥58.0 Diopters (D). Inclusion criteria were Kmax ≥58.0 D and minimum follow-up of 1 year. Corneal topography and tomography were performed preoperatively and at 1 and 2 years. Sixty-one eyes of 56 patients with mean age of 24.9 ± 8.6 years (mean ± SD, range 12-57 years) had 1-year follow-up. Fifty of these eyes had 2-year follow-up. The definition of progression was an increase in Kmax of ≥1.0 D over 1 year.

RESULTS

Mean Kmax was 63.9 ± 6.1 D (mean ± SD, range 58.2-87.0 D) preoperatively (n = 61) and 62.9 ± 5.9 D (range 54.6-82.5 D) after 1 year. This represented a significant decrease in steepness (P = 0.0029). Mean pachymetry decreased significantly from 433.7 ± 44.8 μm preoperatively to 423.0 ± 41.8 μm (P = 0.001) at 1 year. Progression occurred in 14 of the 61 eyes (23%) at 1 year, and 5 (8.2%) steepened more than 2.0 D. In the group with 2-year follow-up, mean Kmax was 63.0 ± 5.0 D (range 58.2-87 D) before CXL and decreased to 61.5 ± 4.8 D (range 53.6-78.3 D) at 2 years (P = 0.001). Nine of the 50 eyes (18%) showed an increase of Kmax of ≥ 1 D.

CONCLUSIONS

The incidence of progression (23% at 1 and 18% at 2 years, respectively) is considerably higher than in previously reported results of CXL in eyes with mean Kmax ≥58.0 D. To the best of our knowledge, this study represents the largest number of such steep corneas analyzed with respect to long-term progression after CXL.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Tappeiner, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0277-3740

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Christoph Tappeiner

Date Deposited:

01 Feb 2019 11:15

Last Modified:

01 Dec 2020 02:30

Publisher DOI:

10.1097/ICO.0000000000001736

PubMed ID:

30157048

BORIS DOI:

10.7892/boris.123075

URI:

https://boris.unibe.ch/id/eprint/123075

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