Hormonal effect on progression of corneal ectasia

Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 14:06

Venue: Room A3, Podium 3

First Author: : M.Vesela CZECH REPUBLIC

Co Author(s): :    D. Barakova                    

Abstract Details

Purpose:

The aim of the presentation is to highlight the possible relationship of keratoconus and hormonal disbalance due to the hormonal stimulation prior in vitro fertilization (IVF) treatment.

Setting:

Pilot results of retrospective study in Gemini Eye Clinic, Prague, Czech Republic

Methods:

From 2007 to 2016, the number of IVF treatments in Czech Republic increased from 17 682 to 38 081 per year. Two groups of 38 eyes of 19 patients who manifested progression of keratoconus after hormonal stimulation within the IVF treatment were evaluated. Group A (26 eyes of 13 patiens) included candidates for refractive surgery. Group B (12 eyes of 6 patients) had advanced keratoconus and the CXL was performed to halt keratoconus progression.The age of patients, number of IVF treatments, refractive error, keratometry values, corneal thickness, presence of hormonal and other systemic disorders and oral administration were evaluated.

Results:

Group A:The mean age of patients was 36.07±5.53 years and number of IVF treatments was 2.38±1.50 underwent in years 2009-2018.The mean UDVA was 0.22±0.19 and CDVA 1.00 in Snellen line.The mean manifest spherical diopters was -1,95±1.19D, astigmatism -0,83±0.71Dcyl.The mean Kmax was 45.89±1.91D.The mean thinnest corneal thickness was 512.92±45.63μm.Tomography revealed corneal instability patterns or fruste forme of keratoconus. Group B:The mean age of patients was 33.16±0.75 years.The mean number of IVF treatments was 5.00± 2.75 underwent in years 2009-2018.Accelerated cross-linking 9 mW/cm2 for 10 minutes was performed to halt progression of keratoconus.

Conclusions:

Due to an increase in IVF treatment in Czech Republic, more careful selection of convenient candidates for laser refractive surgery is required. Monitoring of patients with increased risk of corneal ectasia, early diagnosis of keratoconus and its treatment using the corneal cross-linking will help to halt progression of keratoconus, stabilize the cornea and prevent the corneal transplantation. A statistical comparison of the incidence of corneal ectasia in a larger group of women after hormonal stimulation during IVF treatment with a control group would be appropriate for assessing the risk ectasia induced by hormonal IVF stimulation

Financial Disclosure:

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