July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
The outcomes of corneal cross-linking for Keratoconus from routine clinical practice across 3 sites in Australia: Results from the Save Sight Keratoconus Registry
Author Affiliations & Notes
  • Alex Ferdi
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Vuong Nguyen
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Jeremy Tan
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Yves Kerdraon
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
    Sydney Eye Hospital, Sydney, New South Wales, Australia
  • John Males
    Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Nigel Morlet
    University of Western Australia, Perth, Western Australia, Australia
  • Peter Beckinsale
    University of Queensland, Brisbane, Queensland, Australia
  • Richard A Mills
    Flinders University, Adelaide, South Australia, Australia
  • Chris Go
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Mark Daniell
    Centre for Eye Research Australia, Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Elsie Chan
    Centre for Eye Research Australia, Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Daniel Barthelmes
    University of Zurich, Zurich, Switzerland
  • Amparo Herrera-Bond
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Marco Garcia
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
  • Mark C Gillies
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
    Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Stephanie L Watson
    Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
    Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Alex Ferdi, None; Vuong Nguyen, None; Jeremy Tan, None; Yves Kerdraon, None; John Males, None; Nigel Morlet, None; Peter Beckinsale, None; Richard Mills, None; Chris Go, None; Mark Daniell, None; Elsie Chan, None; Daniel Barthelmes, None; Amparo Herrera-Bond, None; Marco Garcia, None; Mark Gillies, None; Stephanie Watson, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4380. doi:
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      Alex Ferdi, Vuong Nguyen, Jeremy Tan, Yves Kerdraon, John Males, Nigel Morlet, Peter Beckinsale, Richard A Mills, Chris Go, Mark Daniell, Elsie Chan, Daniel Barthelmes, Amparo Herrera-Bond, Marco Garcia, Mark C Gillies, Stephanie L Watson; The outcomes of corneal cross-linking for Keratoconus from routine clinical practice across 3 sites in Australia: Results from the Save Sight Keratoconus Registry. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4380.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report the 12-month outcomes of 54 eyes undergoing corneal cross-linking (CXL) for keratoconus performed in 3 routine clinical practices in Australia.

Methods : Outcomes and adverse events were recorded prospectively in a custom-designed database, the Save Sight Keratoconus Registry. Index visit parameters, such as visual acuity (VA, in Logarithm of the Minimal Angle of Resolution [logMAR]), maximum keratometry [Kmax], steep keratometry [K2], pachymetry, as well as treatment parameters (epithelial status, riboflavin type, UV duration) were recorded. Index visit parameters associated with the 12-month VA outcome were identified using mixed effects linear regression.

Results : Median change in VA after 12 months was +4.5 logMAR letters (Quartiles 1 and 3 [Q1, Q3]: -4.8, 10.8); Kmax -0.3 D (Q1, Q3: -2.3, 0.4); K2 -0.2 (Q1, Q3: -1.4, 0.3) and pachymetry -14.0 microns (Q1, Q3: -23.8, -2.0). There was a significant improvement in VA (p = 0.048), reduction in Kmax (p = 0.027) and reduction in pachymetry at 12 months (p = 0.002). VA at the index visit was the strongest predictor for the 12-month VA outcomes (p < 0.001). There was no significant change in K2 at 12 months (p = 0.074).

Treatments were epithelial-off (n=54) with UV exposure that was accelerated (n= 40) or according to the Dresden protocol (n=14).

Adverse events occurred in 31 eyes and included corneal haze (27 eyes), microbial keratitis (1 eye), persistent epithelial defect (4 eyes), scarring (4 eyes), and sterile infiltrates (1 eye) from a total of 54 eyes within the first 12 months of follow-up. Haze was recorded in 7 eyes during the second year of follow-up. Eyes that experienced microbial keratitis or scarring within the first 12 months of follow-up had a median VA loss of -15 and -9 (Q1, Q3: -17.5, -2.25) letters at 12 months, respectively. Eyes that experienced haze, persistent epithelial defect or sterile infiltrates within the first 12 months of follow-up had a median VA change of +6 (Q1, Q3: -1, 11), +4 (Q1, Q3: 1.75, 6.0) and +0 letters at 12 months, respectively.

Conclusions : In routine clinical practice CXL can stabilize visual acuity and keratometric parameters. Although complications such as keratitis or scarring can result in visual loss, corneal haze does not appear to have a detrimental effect on visual outcomes at 12 months.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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