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Corneal curvature and thickness in keratoconus after corneal cross-linking: does age have an effect?

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First Author: B.Alenezi UK

Co Author(s):    C. Hillarby   F. Khoyratty   H. Radhakrishnan              

Abstract Details

Purpose:

The study aims to explore whether corneal curvature and thickness measurements differ following corneal cross-linking (CXL) treatment in different age groups in a keratoconic population.

Setting:

Retrospective single-center study carried out at Manchester Royal Eye Hospital, the UK.

Methods:

A total of 208 eyes of 197 progressive keratoconic patients (130 males) aged 13 to 52 years old were recruited in the study. Epithelium-off CXL procedure was performed for all patients using accelerated CXL (UV-A irradiation with 9.86mW/cm2 for 9 minutes) and riboflavin. Patients were divided into three age groups: Group A (13-18 years), Group B (19-27 years) and Group C (28-and above) to investigate the effect of patient’s age on CXL long-term outcomes. Corrected distance visual acuity (CDVA), corneal curvature and thickness were measured preoperatively and at 1, 2 and 3 years post-CXL treatment using the Oculus Pentacam.

Results:

Results showed a significant improvement in CDVA from 0.46 to 0.30 logMAR (p<0.05) at 3 years follow-up. At the end of observation, maximum keratometry (Kmax) reduced significantly from 64.35±6.62 to 63.02±6.58 by 1.31±3.00 (p<0.001). Thinnest pachymetry (T pachy) showed a significant reduction at each annual observation following CXL compared to its baseline measurements (p<0.0001 for each). CXL treatment induced a reduction in Kmax measurements in all age groups at 3 years follow-up; however, the induced reduction was significant only for the younger group, Group A (1.71±3.01, p=0.03). Kmax reduced by ≥1 diopter in more than 61% of eyes in Group A compared to 40% and 35% of eyes in Group B and Group C respectively. Measurements of T pachy showed a significant reduction in groups A and B at 3 years following CXL, whereas, group C was less affected by CXL.

Conclusions:

The findings of the current study demonstrated the effectiveness of CXL to stabilise the progression of keratoconus and significantly improve corneal curvature measurements for long-term observation. The stabilisation in keratoconus was more pronounced in younger eyes compared to older eyes. Corneal thickness seems to significantly reduce after CXL at short and long-term follow-ups. The impact of CXL on corneal thickness appears to significantly affect younger groups (those up to 27 years old), however, corneal thickness is less likely to be influenced by CXL in older keratoconus patients.

Financial Disclosure:

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