Customised CXL for keratoconus: 3 year results

Session Details

Session Title: Cross-Linking

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

Paper Time: 15:38

Venue: Room A3, Podium 3

First Author: : T.Seiler SWITZERLAND

Co Author(s): :    T. Koller   B. Frueh   T. Seiler              

Abstract Details

Purpose:

To compare the efficacy of customized corneal crosslinking (CXL) with standard CXL with a follow-up of 3 years and to compare 1-year to 3-year results.

Setting:

Prospective, nonrandomized comparative clinical study at the Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Switzerland.

Methods:

Forty eyes of 40 patients with documented progressive primary keratoconus were treated with customized CXL (n = 20) or standard CXL (n = 20) and followed for 3 years. Customized irradiation patterns had an irradiance of 9mW/cm2 and total energy levels ranging from 5.4J/cm2 up to 10J/cm2 and were centered on the maximum of the posterior float. The control group received homogenous irradiation with an irradiance of 9mW/cm2 and a total energy of 5.4J/cm2. Scheimpflug tomographies, endothelium cell count, BSCVA, and anterior segment OCT were compared preoperatively and up to 3 years postoperatively.

Results:

Kmax showed significant changes within 3 years postoperatively for both groups with a significantly higher regression in the customized CXL subgroup (-2.1 ±2.0D vs. -1.1±1.3D). During the second and third postoperative year additional regularization occurred in the customized group but not in the standard group. Nine out of 19 eyes (56%) in the customized CXL group but only 2 out of 19 (11%) in the standard group showed a flattening of 2 or more diopters (p<0.05). Pachymetry showed only significant changes within the first postoperative year. The regularization index (RI) was significantly better in the customized CXL group.

Conclusions:

Customized CXL appears to be as safe as standard CXL with stronger qualitative and quantitative flattening in Kmax and RI. Compared to the 1-year results there is a further improvement in corneal regularization in Kmax and RI in customized CXL after 3 years.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented