Posters

Long-term evaluation of two cross-linking profiles in treatment of progressive keratoconus

Poster Details

First Author: E. Vounotrypidis GERMANY

Co Author(s):    A. Athanasiou   M. Mueller   K. Kortuem   C. Kern   S. Priglinger   W. Mayer     

Abstract Details

Purpose:

To evaluate long-term efficacy of accelarted versus standard collagen cross linking (CXL) in eyes with progressive keratoconus.

Setting:

Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany

Methods:

384 eyes of 281 patients with progressive keratoconus were treated with UV-X1000 (n=198, group A, (3 mW/cm² UV-A for 30 minutes) or UV-X2000 (n=186, group B,9 mW/cm² UV-A for 10 minutes).343 eyes of the 384 received CXL using isotone riboflavin and processed for evaluation. Over the course of more than 2 years visual acuity as well as topographic parameters (Scheimpflug imaging) were retrospectivley evaluated and compared between both groups. Main parameters include topographic ones (K1, K2, Kmax, Km and astigmatism) pachymetric ones (thinnest corneal thickness (TCT)) and keratoconus indices (KI, CKI). Central tendency, predictive fits and regression models, were computed.

Results:

Visual acuity improved in both groups (gain of 0.12 logMAR in group A, 0.14 logMAR in group B). Kmax decreased in both groups, but not significant (1D in group A, 1.25D in group B).TCT and keratoconus Indices improved significant in group B compared to A (p=0.025 for TCT, p=0.001 for KI). Subgroup analyzes of mild and moderate keratoconus grade according to Kmax (<58D and >58D) showed no difference between groups with regard to visual acuity, KI or Kmax, but TCT and CKI improved significantly more in group B in patients with baseline Kmax <58D (p=0.024). A correlation of Kmax and IVA, ISV and KM improvement was detected earlier in Group B, but was not significant over the follow up time.

Conclusions:

Both CXL protocols showed similar results, however subgroup analyzes (mild keratoconus grade with Kmax <58D) showed an overall better improvement of all pachymetrical data as well as lower regression of keratometry values over a course of at least two years follow-up evaluation. Moreover, accelerated CXL seems to offer a quicker regression of the K-values, with a quicker visual acuity improvement, especially in cases of lower grade Keratoconus.

Financial Disclosure:

NONE