Abstract
Purpose :
To investigate the functional and anatomical long-term results after corneal collagen crosslinking (CXL) for progressive keratoconus (KC) in pediatric and adult population.
Methods :
In this prospective study, patients with progressive KC underwent epithelium-off CXL. Pre-CXL, 12 and 24 months postoperative visits included: slit lamp examination, corneal epithelial fluorescein staining, best spectacle-corrected visual acuity (BSCVA), anterior segment optical coherence tomography, corneal topography with surface asymmetry index (SAI) and surface regularity index (SRI) and, in vivo confocal microscopy (IVCM). Data were analyzed by the paired t-test.
Results :
Sixty-three eyes of 55 patients completed the 24-month follow-up. Twenty (32%) procedures were performed in pediatric patients (age <18), 29 (46%) in women. No significant functional and anatomical differences between groups were observed at the baseline. After two years, the anterior corneal astigmatism reduction from baseline was -0.48 D (95% CI -0.79 to -0.14; p=0.01) and -0.65 D (95% CI -1.76 to 0.43 p>0.05), respectively in the adult and pediatric population, with no significant changes from the 12-months visit. In both groups, the 12-month post-CXL improvements of the BSCVA, SAI and SRI persisted at 24-month. Between 12 and 24 months, an increase of sub-basal nerve length and density were observed by IVCM in both groups (p<0.05).
Conclusions :
Our data show the effectiveness of CXL in halting progression of KC at 2 years in the pediatric and adult population. IVCM revealed that nerve regeneration continues in the long-term after CXL.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.