Posters

Customised corneal cross-linking for keratoconus treatment: first experience

Poster Details

First Author: Z.Halasova SLOVAKIA

Co Author(s):    P. Stodulka   M. Slovak                 

Abstract Details

Purpose:

Topography guided corneal crosslinking as a new method of keratoconus treatment is evaluated. This personalized customization of the UVA beam pattern to localization of the individual corneal conus should not only cause local stiffening but also enhanced flattening of the conus and therefore modify corneal shape and consequently improve visual functions. Topographic and subjective visual outcomes of customized crosslinking method (CuRV) for keratoconus treatment were assessed.

Setting:

Gemini Eye Clinic, Prague and Zlin, The Czech Republic

Methods:

10 eyes with keratoconus grade 1-3 underwent customized topography guided cross-linking with epi-on protocol. Pulsed UVA 30mW/cm2 irradiation was delivered to the cornea in 3 circular areas with gradual increase in energy, where apex of keratoconus was exposed to the highest energy of 15J, intermediate annulus getting 10J and peripheral annulus only 7.2J. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, distance refraction (Sp.Eq), pachymetry and endothelial cell density were recorded during 6 months follow-ups. Mean changes in Axial Sagittal curvature on Scheimpflug tomography (Pentacam) were performed using a purpose made algorithm (Octave 4.4.1). Measurements of VAs at far distance (UDVA, CDVA) with and without correction, distance refractive errors (dSp.Eq), pachymetry and endothelial cell density were recorded during 6 months follow-ups. Mean changes in Axial Sagittal curvature (Pentacam) were performed using a purpose made algorithm (Octave 4.4.1).

Results:

We observed a significant improvement in UDVA immediately after the surgery 0.16 (0.022 to 0.033, 95% CI) logMAR in 1week and 0.063 (-0.12 to 0.24, 95% CI) in 1 month. There was also improvement in CDVA postoperatively 0.042 (-0.014 to 0.098, 95% CI). Corneal curvature map showed flatting of central area by on average -3D.
 Endothelial cell density was stable and did not show significant changes with slight decrease by 331 cells per mm2 (-42 to 704, 95% CI) in 1month follow-up.

Conclusions:

First short-term experience with customized cross-linking (CuRV) is showing promising results. There was no progression of keratoconus noted and treatment achieved marked topographic improvement with better functional vision. CuRV seems to be a safe and effective procedure, however longer follow-up on higher amount of patients is needed in order to determine the long-term safety and efficacy.

Financial Disclosure:

None