Effective corneal collagen crosslinking in advanced cases of progressive keratoconus

J Cataract Refract Surg. 2013 Aug;39(8):1141-5. doi: 10.1016/j.jcrs.2013.01.045. Epub 2013 May 24.

Abstract

Purpose: To evaluate the 1-year results of corneal collagen crosslinking (CXL) in mild to moderate cases and advanced cases of progressive keratoconus.

Setting: Department of Ophthalmology, University Medical Center Utrecht, the Netherlands.

Design: Retrospective cohort study.

Methods: Eyes with progressive keratoconus had CXL between January 2010 and April 2011. Patients were divided into 2 subgroups as follows: Group 1, mild to moderate keratoconus with a preoperative maximum keratometry (K) of less than 58.0 diopters (D), and Group 2, advanced keratoconus with a maximum K of 58.0 D or more. Visual acuity, refraction, and elevation-based topography were evaluated at baseline and 12 months after CXL.

Results: The study comprised 53 eyes of 42 patients. In the overall group, progression was halted in 48 eyes (91%). The CXL-induced corneal flattening occurred in 11 (42%) of 26 eyes in Group 1 and 20 (74%) of 27 eyes in Group 2. Five of 7 keratoconus indices improved 12 months after CXL. The failure rate was comparable in the subgroups (3 eyes in Group 1, 2 eyes in Group 2). No major complications occurred in either subgroup.

Conclusions: Stabilization after CXL was achieved in mild to moderate cases and advanced cases of progressive keratoconus. The amount of failure was comparable in the 2 subgroups. The CXL-induced flattening was more pronounced in the advanced subgroup.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cohort Studies
  • Collagen / metabolism*
  • Corneal Pachymetry
  • Corneal Stroma / metabolism*
  • Cross-Linking Reagents / therapeutic use*
  • Female
  • Humans
  • Keratoconus / drug therapy*
  • Keratoconus / metabolism
  • Keratoconus / physiopathology
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Prognosis
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Riboflavin / therapeutic use*
  • Ultraviolet Rays
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin