Accelerated Epithelium-Off Corneal Collagen Cross-Linking For Keratoconus: 12-Month Results
Received 27 September 2019
Accepted for publication 22 October 2019
Published 4 December 2019 Volume 2019:13 Pages 2385—2394
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Nicola Ludin
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Ismail Ahmed Nagib Omar, Hosny Ahmed Zein
Ophthalmology Department, Faculty of Medicine, Minia University, El-Minya, Egypt
Correspondence: Ismail Ahmed Nagib Omar
Ophthalmology Department, Faculty of Medicine, Minia University, P O Box 61519, El-Minya 61111, Egypt
Purpose: The main aim of the study was to report visual, refractive, topographic, and aberrometric results of accelerated CXL in patients with keratoconus who were followed for 12 months and to highlight the important parameters that can be used in follow-up.
Settings: It was a prospective interventional non-randomized case series study, in which 40 keratoconus eyes of 40 patients were studied in the period between April 2016 and July 2018.
Methods: All eyes were examined preoperatively and post-accelerated CXL to evaluate visual acuity, refractive state, keratometric values, keratoconus indices, and corneal higher order aberrations (HOAs).
Results: The mean age of the studied patients was 28.4 ± 8.6 years (18–37years). One year after cross-linking, 11.6% of the eyes gained two lines of the UCVA, 26.4% of the eyes gained one line, 49.8% showed no change, 7.1% lost one line, and 5.1% lost two lines. Postoperative BCVA showed 13.7% of the eyes gained at least two lines, 32.5% gained one line, 49.9% had no change, and 3.9% lost one line. The keratometric values changed significantly after CXL; K1 decreased by a mean of 0.41D, K2 by 0.62D while Kmax by 1.57 D. The significant changes in keratoconus indices were in index of vertical asymmetry (IVA), index of surface variance (ISV), and keratoconus index (KI). Vertical coma, spherical aberrations, and trefoil decreased significantly at 12 months compared to baseline values (p = 0.04, 0.017, 0.025, respectively).
Conclusion: Keratoconus indices especially ISV, IVA, and KI along with HOAsparticularly vertical coma, spherical aberrations, and trefoil can add value beside keratometric readings in the follow-up of eyes treated with accelerated CXL.
Keywords: accelerated, cross-linking, keratoconus, aberrations
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