Accelerated corneal collagen cross-linking: 1,2 and 3 year tomographic and visual outcomes

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Saturday 22/02/2020 | 08:30-11:10
Paper Time: 08:48
Venue: Auditorium des Ministres.

First Author: S.Khan UK
Co Author(s): P. Jaycock                 

Abstract Details

Purpose:

The aim of the study was to report the effectiveness of accelerated corneal collagen cross-linking (CXL) in stabilising corneal shape at 1,2 and 3 years following treatment and to determine effect of CXL on visual acuity.

Setting:

Bristol Eye Hospital, United Kingdom.

Methods:

A retrospective case review of 335 patients treated for progressive keratoconus between 2015 - 2018 was completed. 223 patients had 1 year outcome data, 108 had 2 year outcome data and 40 had 3 year outcome data. Patients were treated with a continuous wave epithelium-off accelerated CXL (irradiance of 9 mW/cm2; 10 minutes) protocol using Avedro KXL device.   Visual acuity and keratometric values pre-treatment and post-treatment were compared at time points 0,1,2 and 3 years using paired statistical analyses. Subgroup analyses were performed based on age (<18 years and ≥18 years), gender and grade of keratoconus using the Amsler-Krumeich classification.

Results:

Average Kmax after CXL was significantly reduced in years 1,2,3 following treatment: 59.10D vs 58.30D, 58.85D vs 57.70D and 60.05D vs 58.80D, respectively. Post-treatment outcomes compared between all years found no significant ongoing corneal flattening. Male to female ration was 4:1. Gender and age were not factors affecting the success of the CXL procedure. Best spectacle-corrected visual acuity (BSCVA) outcomes at 1 year: 11% gained ≥ 2 lines, 4.5% lost ≥ 2 lines (no patient lost more than 2 lines), 79% were unchanged at ± 1 line, 4.5% were undocumented. Median BSCVA at 1 year was unchanged: 0.67 Decimals.

Conclusions:

The accelerated 9mW/cm2 protocol resulted flattening of the corneal shape at 1 year post-treatment and this remained stable up to 3 years post-operatively.

Financial Disclosure: