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Takashi Kojima, Tomoaki Nakamura, AKENO TAMAOKI, Kazuo Ichikawa; Three-year outcomes of corneal crosslinking in progressive keratoconus. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3501.
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To report the 3-year outcomes of corneal crosslinking in progressive keratoconus.
Patient medical charts were retrospectively reviewed, and 25 eyes of 19 patients who completed 3 years of follow-up were enrolled in this study. Average patient age at the time of surgery was 22.6 ± 5.6 years. All eyes were treated by corneal crosslinking in accordance with the Dresden protocol. Briefly, the corneal epithelium was removed and riboflavin eye drops were applied for 30 min. After confirming riboflavin penetration through the entire thickness of the cornea, ultraviolet irradiation (3 mW/cm2, Opto Xlink) was administered. Isotonic or hypotonic riboflavin ophthalmic solution (Opto Ribolink) was administered in accordance with intraoperative corneal thickness. Kaplan–Meier analysis was performed to assess the effect corneal crosslinking on arresting disease progression. Surgery was considered to have failed at average K values > 1 D.
The mean uncorrected visual acuity at 3 years post-surgery (logMAR[decimal], 0.35 ± 0.27[0.45]) was significantly better compared to the preoperative value (0.56 ± 0.38 [0.24]). There were no significant differences in corrected visual acuity between baseline and 3 years post-surgery (p = 0.20). While the mean K value had significantly decreased between baseline and 3 years post-surgery (46.8 ± 3.9 D and 46.2 ± 4.4 D, respectively; p = 0.018), the mean corneal endothelial cell density did not exhibit a significant change (2836 ± 372/mm2 and 2725 ± 380/mm2; p = 0.32). Two eyes exhibited an increase in average K value of > 1 D during the follow-up period. The total success rate was 92%. Three eyes exhibited mild corneal opacities in the deep corneal stroma 3 years post-surgery.
Corneal crosslinking is a safe and effective method for arresting the progression of keratoconus. Careful follow-up is required to assess disease progression.
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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