Corneal collagen cross-linking for keratoconus in young patients: three year follow-up

Session Details

Session Title: Cross-linking I

Session Date/Time: Monday 15/09/2014 | 14:30-16:30

Paper Time: 14:48

Venue: Capital Hall A

First Author: : D.Wajnsztajn ISRAEL

Co Author(s): :    B. Rosin   S. Frenkel   E. Strassman   D. Landau   J. Frucht-Pery  

Abstract Details

Purpose:

To report the 3 year outcomes of corneal collagen crosslinking (CXL) treatment for keratoconus (KC) in children and adolescents.

Setting:

Hadassah Medical Center - Hebrew University Hospital, Ophthalmology Department, Jerusalem, Israel

Methods:

We retrospectively reviewed all files of patients younger than (including) 18 years, who underwent CXL for KC (August 2007 to March 2013). Principal outcomes were best corrected visual acuity (BCVA, in LogMAR), topography derived maximum keratometry (Kmax), topographic cylinder, mean keratometry (mean K, central 3mm zone) during the first 3 years post-CXL. Procedures were done using Dresden protocol with regular or hypotonic riboflavin (UV-X ™ Specifications, IROC, Zurich, Switzerland). Statistical analysis was performed by Wilcoxon Rank Sum Test using Matlab 2013b, The Mathworks Inc, Natick MA.

Results:

Fifty six eyes of 47 patients (41 males) 18 years old or younger (mean age 16±1.9yrs, ranging from 11 to 18yrs) had CXL for KC. Pachymetry pre-CXL was 445.3±45.8μm (range:328-523μm). After 1 year (n=50 eyes) Kmax, mean K, topographic cylinder, and BCVA changed from 55.4±5.9D to 52.9±5.34D (p=0.0452), from 50.4±5.5D to 48.9±5.2D (p=0.1833), from 3.31±1.5D to 2.85±1.3D (p=0.1635) and 0.36±0.2 to 0.32±0.3 (p=0.1408) respectively. After 2 years (n=25 eyes) Kmax, mean K, topographic cylinder, and BCVA changed from 55.4±6.2D to 52.1±5.3D (p=0.0824), from 50.5±5.8D to 48.1±4.7D (p=0.1969), from 3.24±1.4D to 3±1.4D (p=0.5030) and 0.33±0.2 to 0.27±0.2 (p=0.1105) respectively. After 3 years (n=22 eyes) Kmax, mean K, topographic cylinder, and BCVA changed from 57.9±6.7D to 54.5±6.7D (p=0.0693), from 51.2±5.5D to 50.2±5.9D (p= 0.3345), from 4.66±3.2D to 3.28±1.5D (p=0.2073) and 0.34±0.2 to 0.24±0.2 (p= 0.1901) respectively. Five eyes had epithelium delayed healing, 1 eye had sterile infiltrates and 5 eyes had haze that did not affect BCVA. Two eyes lost 2 lines of BCVA. One eye had re-treatment due to KC continuous progression.

Conclusions:

CXL is a safe and efficacious procedure for treatment of KC progression in young patients.

Financial Interest:

NONE