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Long term outcomes of corneal cross-linking for keratoconus: a Save Sight Keratoconus Registry study

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First Author: S.Watson AUSTRALIA

Co Author(s):    A. Ferdi   V. Nguyen   H. Kandel   J. Tan   F. Arnalich-Montiel   M. Abbondanza     

Abstract Details

Purpose:

To report the outcomes of 711 eyes of 572 patients undergoing corneal cross-linking (CXL) for keratoconus performed in 25 centres across Australia, New Zealand, Spain and Italy.

Setting:

Data from routine clinical practice was captured through the Save Sight Keratoconus Registry.

Methods:

Keratoconus patients who had undergone epithelium-off CXL, and who had not had any prior intervention, were included. Primary outcomes included the final visual acuity (VA), measured with the patient’s habitual visual correction method, Kmax, K2 and thinnest corneal thickness (TCT) at 1 to 5-years. Secondary outcomes included the percentage of 1 to 5-year completers with worsening, stable and improving VA, Kmax, K2 and TCT. CXL ultraviolet light protocols and the frequency of adverse events were also reported.Eligible for inclusion were 711 eyes (1 year), 355 (2 years), 252 (3 years), 179 (4 years) and 122 (5 years).

Results:

For the 5-year completers, the mean visual acuity improved by 7.9 (3.4, 12.3) logMAR letters (p=0.003). Conversely, mean change in Kmax (-1.5 D), K2 (-0.7 D), and TCT (-9.1 µm) was not statistically significant (p values, 0.22, 0.34 and 0.16 respectively). The proportion of eyes that gained 15 or more letters increased from 13.1% to 24.6% from 1 to 5 years. Similarly, the proportion of eyes that flattened with 2D or more change in Kmax increased from 29.6% to 43.2% from 1 to 5 years. The most commonly used UV duration was 10 (385 eyes) and 30 (261 eyes) minutes. The eyes with presence of haze reduced from 14.2% at 1 year to 1.6% at 5 years.

Conclusions:

Our real-world data across multiple countries CXL as an effective treatment for progressive keratoconus, with positive outcomes including improved VA and stable Kmax, K2 and TCT sustained at 5 years. CXL has a good safety profile with few adverse events occurring, particularly at 5 years.

Financial Disclosure:

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