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Samar A Al-Swailem, Salem Al Zaid; Four-year results of riboflavin ultraviolet-A corneal collagen cross-linking for progressive corneal ectasia in 129 eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2898.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical course of conventional corneal collagen cross-linking (CXL) with up to 4.7 years of follow-up, for the treatment of progressive corneal ectasia. At the baseline and all follow-up examinations, Snellen uncorrected visual acuity (UCVA), Snellen best corrected visual acuity (BCVA), keratometry, central corneal thickness (CCT), and complications were analysed.
The records of 129 eyes (keratoconus = 114; post-excimer ectasia=15) which underwent CXL using Dresden’s protocol, were reviewed retrospectively.
The mean age of the 83 men and 46 women was 24.73± 5.5 (Range 14-42) years, and 68.2% were in the age range of 21-30 years. The CCT almost resumed its baseline reading at 9-months postoperatively (460.5 vs. 479.7um), and stabilized until the last follow-up (465.3um) (p<0.086). At last follow-up, median simulated mean keratometry decreased from 45.1±3.6D (range 37.9-66.9D) to 44.5±3.6D (range 37.6-60.5D) (p<0.008). At last follow-up, median UCVA and BCVA changed from 20/60 to 20/40 and 20/25 to 20/25, respectively. The UCVA of ≥20/40 was recorded in 38.8% and 53.3% before and after CXL, respectively. At last follow-up, mean UCVA improved and worsened by ≥ 1 Snellen line in 27.1% and 10.8%, respectively. Complications included: transient corneal haze in first 3 months (n=9) and sterile infiltrate (n=3).
Our study not only demonstrated a halt in ectasia progression, but also showed a significant improvement in visual acuity at 4-year of follow-up. Conventional CXL is safe in stabilization of progressive ectasia. Given the simplicities, minimal costs of CXL and likelihood of reducing the need of keratoplasty, it might also be well-suited for developing countries.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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