Long Term Corneal Flattening After Corneal Crosslinking in Patients with Progressive Keratoconus

Purpose: We evaluate the long-term visual, refractive, and keratometric outcomes after corneal crosslinking (CXL) in patients with progressive keratoconus (KC) and the incidence of an extreme corneal flattening effect. Settings: Oftalmosalud Institute of Eyes, Lima, Perú. Design: Retrospective cohor...

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Autores principales: María A. Henríquez, Lisett Perez, Gustavo Hernandez-Sahagun, Rolando Rojas, R. Doyle Stulting, Luis Izquierdo
Formato: Artículo
Lenguaje:inglés
Publicado: 2023
Materias:
Keratoconus
Medicine
Ophthalmology
Corneal topography
Term (time)
Flattening
Optometry
Cornea
Quantum mechanics
Materials science
Physics
Composite material
Health Sciences Medicine Radiology, Nuclear Medicine and Imaging Corneal surgery and disorders
Health Sciences Medicine Radiology, Nuclear Medicine and Imaging Corneal Surgery and Treatments
Health Sciences Medicine Public Health, Environmental and Occupational Health Ocular Surface and Contact Lens
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Ver en el sistema de origen
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Sumario:Purpose: We evaluate the long-term visual, refractive, and keratometric outcomes after corneal crosslinking (CXL) in patients with progressive keratoconus (KC) and the incidence of an extreme corneal flattening effect. Settings: Oftalmosalud Institute of Eyes, Lima, Perú. Design: Retrospective cohort study. Methods: Forty-five eyes that underwent CXL with epithelial removal between June 2006 and September 2011. Data analysis was performed at preoperative evaluation, 1 year postoperatively, and at least 10 years or more postoperatively. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and Scheimpflug (Pentacam) analysis. Progression was defined by an increase in steep keratometry (Ks) of 1.5D or greater between 2 examinations. Extreme flattening effect was defined as a decrease in K values equal to or greater than 5 diopters (D). Results: Mean follow-up time was 11 ± 1.07 years (range 10-13 years). There was a significant improvement in Ks, UCVA, CDVA, and spherical equivalent at the last visit. The overall rate of progression was 2.22% (1/45). Extreme flattening was observed in 15.5% (7/45) of the eyes, and this was associated with a loss of CDVA in 4.44% (2/45) of the eyes. One eye with corneal flattening of 11.5 D lost 7 lines of CDVA and required corneal transplantation. Conclusion: CXL is a safe and effective procedure to stop the progression of KC with a good overall long-term success rate. Extreme corneal flattening may be more common than commonly recognized, and severe corneal flattening associated with a decrease in CDVA may occur.

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