Risk Factors For Progression Following Corneal Collagen Crosslinking In Keratoconus

The Mean ◽

Abstract Purpose: To assess risk factors for progression following corneal collagen crosslinking (CXL) in eyes with keratoconus. Methods: Charts of patients who developed progression following conventional CXL treatment (Dresden protocol) were retrospectively evaluated in two centers (Center 1, and Center 2). 871 eyes of a total of 676 patients were analyzed. Progression was defined as >1 diopter (D) increase in maximum keratometry (Kmax) readings compared to baseline. Results: Progression was noted in 20 eyes of 20 patients (progression rate 3%). The mean age of the patients was 17.65 ± 5.76 (11–34) years and the mean follow-up following CXL was 36.70 ± 25.72 (12–84) months. The gender distribution was 13 (65%) females, and seven (35%) males. Four eyes (20%) had mild, 13 eyes (65%) had moderate, and three eyes (15%) had severe keratoconus at baseline. Fifteen eyes (75%) had allergic conjunctivitis and 20 eyes (100%) reported eye-rubbing. Cone location was central in 17 (85%) eyes and peripheral in 3 (15%) eyes. A mean of 2.21 ± 1.30 D (1.00 – 5.30 D) steepening was determined at Kmax 6 to 82 months following CXL treatment. Conclusions: Progression rate was found to be higher in the patients under the age of 17 years, female gender, allergic conjunctivitis, high preoperative Kmax (>57 D), thin corneas (<430 µm) . The majority of progressive patients were central cone and moderate keratoconus.

Long-term efficacy and safety after corneal collagen crosslinking in pediatric patients: Three-year follow-up

European Journal of Ophthalmology ◽

10.1177/1120672118760149 ◽

2018 ◽

Vol 28 (4) ◽

pp. 415-418 ◽

Cited By ~ 10

Author(s):

Maria A Henriquez ◽

Sandra Villegas ◽

Mirel Rincon ◽

Carmen Maldonado ◽

Luis Izquierdo

Keyword(s):

Visual Acuity ◽

Progression Rate ◽

Collagen Crosslinking ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Best Corrected Visual Acuity ◽

Purpose: To evaluate the effectiveness of standard corneal collagen crosslinking for children with progressive keratoconus. Methods: Prospective study including 26 eyes of 26 patients younger than 18 years old with progressive keratoconus at Oftalmosalud Instituto de Ojos, Lima, Peru. Standard epi-off corneal crosslinking was performed in all eyes between January 2012 and January 2013. Pre- and postoperative evaluation (at 3 years) included uncorrected and best-corrected visual acuity and Scheimpflug analysis. Crosslinking failure was defined as an increase in maximum keratometry (Kmax) of more than 1 diopter after 1 year or more. Results: Mean uncorrected visual acuity improvement was 0.24 LogMAR (p = 0.07) and mean best-corrected visual acuity improvement was 0.18 LogMAR (p = 0.01). None of the eyes lost more than one line in the best-corrected visual acuity. Four eyes (15.38%) lost two lines in the uncorrected visual acuity at 3 years postoperative. Mean steeper keratometry improvement was 1.14 diopters (p = 0.60). Progression rate was 23.07%. Conclusion: Standard epi-off corneal collagen crosslinking is safe and effective to halt the progression of the keratoconus with significant improvement in the best-corrected visual acuity at 3-year follow-up.

Rate of Corneal Collagen Crosslinking Redo in Private Practice: Risk Factors and Safety

Journal of Ophthalmology ◽

10.1155/2015/690961 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Joelle Antoun ◽

Elise Slim ◽

Rami el Hachem ◽

Elias Chelala ◽

Elyse Jabbour ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Private Practice ◽

Allergic Conjunctivitis ◽

Collagen Crosslinking ◽

Factors Associated ◽

Rate Of Progression ◽

History Of ◽

Objective. To report the rate of progression of keratectasia after primary crosslinking (CXL) and evaluate the safety and efficiency of CXL redo.Materials and Methods. We conducted a retrospective analysis of the patients who underwent CXL between 2010 and 2013 at the Beirut Eye Specialist Hospital, Lebanon. Progression of keratectasia was based on the presence of an increase in maximum keratometry of 1.00 D, a change in the map difference between two consecutive topographies of 1.00 D, a deterioration of visual acuity, or any change in the refraction. Primary and redo CXL were done using the same protocol.Results. Among the 221 eyes of 130 patients who underwent CXL, 7 eyes (3.17%) of five patients met the criteria of progression. All patients reported a history of allergic conjunctivitis and eye rubbing and progressed within 9 to 48 months. No complications were noted and all patients were stable 1 year after CXL redo.Conclusion. Allergic conjunctivitis and eye rubbing were the only risk factors associated with keratoconus progression after CXL. A close followup is thus mandatory, even years after the procedure. CXL redo seems to be a safe and efficient technique to halt the progression after a primary CXL.

Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients

BioMed Research International ◽

10.1155/2014/140461 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Deepa Viswanathan ◽

Nikhil L. Kumar ◽

John J. Males

Keyword(s):

Young Patients ◽

Ultraviolet A ◽

Effective Treatment Option ◽

Collagen Crosslinking ◽

Paediatric Patients ◽

Corneal Grafting ◽

Minimum Angle ◽

The Mean ◽

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

Combined small-incision lenticule extraction and intrastromal corneal collagen crosslinking to treat mild keratoconus: Long-term follow-up

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2015.06.027 ◽

2015 ◽

Vol 41 (11) ◽

pp. 2524-2532 ◽

Cited By ~ 8

Author(s):

Enrique O. Graue-Hernandez ◽

Gabriela L. Pagano ◽

Guillermo Garcia-De la Rosa ◽

Arturo Ramirez-Miranda ◽

Jesus Cabral-Macias ◽

...

Keyword(s):

Small Incision Lenticule Extraction ◽

Collagen Crosslinking ◽

Small Incision ◽

Long Term Follow Up ◽

Lenticule Extraction ◽

Complete corneal ring (MyoRing) implantation versus MyoRing implantation combined with corneal collagen crosslinking for keratoconus: 3-year follow-up

International Ophthalmology ◽

10.1007/s10792-017-0593-4 ◽

2017 ◽

Vol 38 (3) ◽

pp. 1285-1293 ◽

Cited By ~ 6

Author(s):

Guzel Bikbova ◽

Gyulli Kazakbaeva ◽

Mukharram Bikbov ◽

Emin Usubov

Keyword(s):

Collagen Crosslinking ◽

Topographic outcomes after corneal collagen crosslinking in progressive keratoconus: 1-year follow-up

Arquivos Brasileiros de Oftalmologia ◽

10.5935/0004-2749.20170023 ◽

2017 ◽

Vol 80 (2) ◽

Cited By ~ 1

Author(s):

Mauro C. Tiveron Jr. ◽

Camila Ribeiro Koch Pena ◽

Richard Yudi Hida ◽

Luciane Bugmann Moreira ◽

Felipe Roberto Exterhotter Branco ◽

...

Keyword(s):

Collagen Crosslinking ◽

EFFICACY OF CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN AND ULTRAVIOLET-A IN PROGRESSIVE KERATOCONUS.

10.36106/ijsr/3021115 ◽

2020 ◽

pp. 1-3

Author(s):

Priyanka Raut ◽

Nikhilesh * Wairagade ◽

Praneeta Sakarkar

Keyword(s):

P Value ◽

Spherical Equivalent ◽

Ultraviolet A ◽

Collagen Crosslinking ◽

Institutional Ethics ◽

Uncorrected Visual Acuity ◽

The Mean ◽

A Prospective Study ◽

PURPOSE-To evaluate outcomes of collagen crosslinking in patients having progressive keratoconus. METHODS- A prospective study was done in eyes that underwent corneal collagen crosslinking for treatment of progressive keratoconus. This study was performed after approval from Institutional Ethics Committee and informed consent was obtained from all the patients. Data was analysed with the help of JASP0.8.3.1 and MS-Excel 2013. RESULT-The mean age was 20.94 ± 2.04 years. 21 (63.63%) were males, 12 (36.36 %) were females. The mean uncorrected visual acuity (UCVA) pre-operative and post-operative at 6 months were 0.64 ± 0.37 and 0.53 ± 0.31 (logMAR) respectively (p value 0.03). Mean spherical equivalent pre-operatively and post-operatively at 6 months were -2.85 ± 2.14 and -2.38 ± 1.70 respectively (p < 0.001). Mean keratometry (Mean K) preoperative and post-operative were 49.85 ± 4.10 Dioptres (D) and 49.22 ± 4.09 D respectively (p = 0.0007). CONCLUSION- Corneal collagen crosslinking with UV-A and riboavin is a safe and effective method for halting the deterioration of progressive keratoconus.