Abdelrahman Salman1, Ali Ali2, Shaaban Rafea3,4, Rana Omran5, Buraa Kubaisi6, Marwan Ghabra7, Taym Darwish2. 1. Honorary Clinical Lecturer at Tishreen University, Scientific Director of Tratous Specialist Eye Center(Tartous, Syria), Lattakia, Syrian Arab Republic. 2. Department of Ophthalmology, 37585Tishreen University, Latakia, Syria. 3. Faculty of Medicine Tartous, 536622Tartous University, Tartous, Syria. 4. Faculty of Medicine, Al-Andalus University for Medical Science, Tartous, Syria. 5. Head of Department of Ophthalmology, Eye Surgical Hospital, Damascus, Syria. 6. Head of Cornea Unit, Eye Surgical Hospital Damascus, Damascus, Syria. 7. 114768Arab International University, Damascus, Syria.
Abstract
AIM: To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. METHOD: In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min "epi-off" corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. RESULTS: Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (-2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR -0.08 ± 0.30) and (LogMAR -0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (-0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from -1.31 ± 0.97 D to -1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (-35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. CONCLUSION: This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.
AIM: To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. METHOD: In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min "epi-off" corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. RESULTS: Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (-2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR -0.08 ± 0.30) and (LogMAR -0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (-0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from -1.31 ± 0.97 D to -1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (-35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. CONCLUSION: This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.
Authors: Le Chang; Lin Zhang; Zhenzhou Cheng; Nan Zhang; Congzheng Wang; Yan Wang; Weiwei Liu Journal: Biomed Opt Express Date: 2022-09-01 Impact factor: 3.562