June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Lifetime Incidence of Corneal Hydrops in Keratoconic Eyes Post Corneal Collagen Crosslinking versus Contact Lens Management
Author Affiliations & Notes
  • Clever Nguyen
    Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Deniz Siso
    Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Nguyen Truong
    Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Jeremy Kudrna
    Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
  • Gargi Vora
    Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Clever Nguyen None; Deniz Siso None; Nguyen Truong None; Jeremy Kudrna None; Gargi Vora None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 666. doi:
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      Clever Nguyen, Deniz Siso, Nguyen Truong, Jeremy Kudrna, Gargi Vora; Lifetime Incidence of Corneal Hydrops in Keratoconic Eyes Post Corneal Collagen Crosslinking versus Contact Lens Management. Invest. Ophthalmol. Vis. Sci. 2023;64(8):666.

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

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Abstract

Purpose : To evaluate the lifetime incidence of acute corneal hydrops (ACH) in eyes with keratoconus (KCN) one-year following corneal collagen crosslinking (CXL) treatment versus those managed with contact lenses (CL).

Methods : A comparative, retrospective cohort study using the TriNetX Research Network registry, aggregating electronic health records from 74 USA-based Healthcare Organizations with 108,290,214 patients on network was performed on January 4th, 2023. ICD-10 and CPT billing codes were used to identify KCN patients (H18.6) and their following initial treatment modality, CXL (0402T) versus CL management (92072) from January 1st, 2016 to current. The primary outcome was the lifetime incidence of ACH (H18.629) as a complication of unstable KCN one year after the cohort's treatment. KCN patients with a history of corneal edema or corneal scars prior to index management and patients with corrective keratoplasty or intracorneal ring segment implantation post-index management were excluded. Baseline characteristic comparison, risk difference analysis, and Kaplan-Meier analysis for event-free survival probability were performed.

Results : 35,141 KCN patients were identified. 3,892 and 987 patients underwent CL management and CXL treatment, respectively. CL patients were older (44.1 ± 15.4 vs. 28.1 ± 11.5 years, p < 0.0001), and had a higher prevalence of female (43% vs 26%, p < 0.0001) and black patients (25% vs 12%, p < 0.0001) at baseline compared to the CXL cohort. 16 CL-managed patients (0.411%) and 10 CXL patients (1.01%) had incidences of ACH one year after their treatment. CXL-KCN patients were associated with a higher absolute risk (risk difference [RD], 0.602%; p < 0.05) and higher likelihood (odds ratio [OR], 2.48; 95% CI, 1.122 - 5.481) of lifetime incidence of ACH compared to the CL-managed group. The CL-managed group had a higher event-free survival probability of acquiring ACH over time relative to the CXL cohort (99.09% vs 96.79%; log-rank test p < 0.0001) and had a lower hazard rate (hazard ratio [HR] 0.207; 95% CI, 0.239 - 0.49).

Conclusions : We report a statistically significant risk reduction in ACH for patients managed with CLs rather than CXL. Clinical significance remains unclear, as ACH represents a rare lifetime complication in both cohorts and patients managed with CXL may be at higher risk for complications in general.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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