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Julie FRANCOIS, SOT Maxime, Marie-Soline LUC, Christophe Goetz, Nadia ouamara, Jean-Marc Perone; Keratoconus and cross linking: Analysis of 90 cases over 3 years. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3499. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study is to describe the refractometric, aberometric and keratometric results in patients with keratoconus treated by the cross linking, at 6 months post-treatment.
Eighty patients (90 eyes) with progressive keratocons treated by cross-linking between March 2014 and May 2016 were included in this study. The procedure was as follows: 10 minutes of UVA irradiation with an intensity of 9 mW / cm (device used: IROC UV-XTM 200, Meduronet). An iso osmolar solution of riboflavin was used for corneas with a pachymetry greater than 450 μm (before epithelialization), whereas a hypo osmolar solution was used for the finer corneas (400-450 μm before de-epithelialisation). Visual acuity, pachymetry, K-max, keratoconus apex localization and higher-order aberrations at 5 mm were measured before and 6 months after treatment
80 patients (90 eyes) with progressive keratocons were included. The sample included 22 women (27.5%) and 58 men (72.5%). The mean age was 26 +/- 10 years. 17 patients (21.25%) were treated for both eyes.The mean pre- and postoperative visual acuity was 0.33 logMAR +/- 20 and 0.29 logMAR +/- 0.19 (p = 0.07), respectively. 38% had a visual acuity increased, 32% had a stable visual acuity, and 30% had a decreased visual acuity. The preoperative Kmax was 57.08D +/- 5.77, the postoperative Kmax of 57.37D +/- 5.89 (p = 0.36). The mean of thinnest pachymetry progressed from 455.31 +/- 34.82 μm preoperatively to 423.96 +/- 48.72 at 6 months (p <0.001). There is no correlation between the thinnest pachymetry and visual acuity (delta = 0.01, p = 0.92). The distance from the cone apex does not change significantly postoperatively (1.29 +/- 0.43 mm vs 1.28 +/- 0.49, p = 0.68). Higher-order aberrations (HAO) at 5mm were measured at 2.67D +/- 1.30 and 2.71 ± 1.24 (p = 0.56) in the pre and post operative, respectively.
Our study confirms the interest of cross linking for stabilization of keratoconus. Indeed, 70% of the patients have a stable or an increased visual acuity post-treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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