Collagen Cross-linking for Advanced Progressive Keratoconus
- 1 July 2013
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Cornea
- Vol. 32 (7), 903-906
- https://doi.org/10.1097/ico.0b013e31828321dd
Abstract
Purpose: Collagen cross-linking (CXL) is a safe and effective procedure to stop progression of keratoconus. However, corneas with a maxK of more than 55 to 58 diopters (D) have been suggested to have an increased failure rate. We report results of CXL for progressive keratoconus in corneas with a maxK of 55 D or more. Methods: Retrospective follow-up. Twenty-eight eyes of 22 patients from 12 to 38 years were treated with CXL for progressive keratoconus. All patients had a preoperative maxK of at least 55 D. Patients were examined on 2 or more occasions after treatment, with a mean follow-up of 22 months. At all visits, patients received routine clinical examination with slit-lamp biomicroscopy, determination of corrected distance visual acuity (CDVA), and Pentacam tomography. Results: The average preoperative maxK was 61.2 ± 3.7 D. After CXL, maxK significantly decreased to 59.5 ± 3.7 D at the last recorded visit. In 27 eyes, keratoconic progression seemed to have stopped, and in 14 eyes maxK improved with more than 2.0 D decrease, whereas 1 eye showed an increase in maxK of more than 2.0 D. The average CDVA remained unchanged after CXL treatment, although 11 eyes improved and 2 eyes had an unexplained loss of CDVA. Conclusions: CXL treatment in eyes with advanced progressive keratoconus prevented further progression in 27 of 28 eyes. Progression in cases with advanced keratoconus should not exclude CXL as a treatment to preserve visual acuity or as a supplement to other treatment modalities to delay or avoid keratoplasty.Keywords
This publication has 14 references indexed in Scilit:
- Corneal collagen crosslinking in progressive keratoconus: Multicenter results from the French National Reference Center for KeratoconusJournal of Cataract & Refractive Surgery, 2011
- Flattening of the cornea after collagen crosslinking for keratoconusJournal of Cataract & Refractive Surgery, 2011
- Corneal Cross-linking with Hypo-osmolar Riboflavin Solution in Thin Keratoconic CorneasAmerican Journal of Ophthalmology, 2011
- Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year resultsJournal of Cataract & Refractive Surgery, 2011
- Long-term Results of Riboflavin Ultraviolet A Corneal Collagen Cross-linking for Keratoconus in Italy: The Siena Eye Cross StudyAmerican Journal of Ophthalmology, 2010
- Complication and failure rates after corneal crosslinkingJournal of Cataract & Refractive Surgery, 2009
- Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: Long-term resultsJournal of Cataract & Refractive Surgery, 2008
- A Randomized Controlled Trial of Corneal Collagen Cross-linking in Progressive Keratoconus: Preliminary ResultsJournal of Refractive Surgery, 2008
- Parasurgical therapy for keratoconus by riboflavin–ultraviolet type A rays induced cross-linking of corneal collagenJournal of Cataract & Refractive Surgery, 2006
- Riboflavin/ultraviolet-a–induced collagen crosslinking for the treatment of keratoconusAmerican Journal of Ophthalmology, 2003