Prospective longitudinal study of corneal collagen cross-linking in progressive keratoconus.

Abstract

BACKGROUND:

Collagen cross-linking has been reported to be effective in treating progressive keratoconus, and this study aims to evaluate the long-term efficacy of this procedure.

DESIGN:

Prospective longitudinal interventional study of patients with progressive keratoconus who underwent cross-linking in a tertiary referral hospital.

PARTICIPANTS:

Thirty-five patients (51 eyes) who underwent cross-linking with a mean follow-up of 14.38 ± 9.36 months (range 6-48) were compared with a control group of 25 fellow eyes that did not undergo the procedure.

METHODS:

Cross-linking was performed using 0.1% riboflavin (in 20% dextran T500) and ultraviolet A irradiation (370 nm, 3 mW/cm(2) , 30 min).

MAIN OUTCOME MEASURES:

Maximum keratometry in dioptres, logMAR best spectacle-corrected visual acuity, cylindrical power, manifest refraction spherical equivalent and central corneal thickness.

RESULTS:

Analysis of the treated group demonstrated a significant flattening of maximum keratometry by 0.96 ± 2.33 dioptres (P = 0.005) and a significant improvement in visual acuity by 0.05 ± 0.13 logMAR (P = 0.04). In the control group, maximum keratometry increased significantly by 0.43 ± 0.85 dioptres (P = 0.05), and visual acuity decreased by mean 0.05 ± 0.14 (P = 0.2). No statistical differences were noted regarding cylindrical power, spherical equivalent or corneal thickness in both groups.

CONCLUSIONS:

Results indicate that corneal collagen cross-linking using riboflavin and ultraviolet A is effective as a therapeutic option in cases of progressive keratoconus by reducing the corneal curvature and by improving the visual acuity in these patients.

• Authors: Deepa Viswanathan, John Males
• Journal: Clinical & experimental ophthalmology (Clin Exp Ophthalmol) Vol. 41 Issue 6 Pg. 531-6 (Aug 2013) ISSN: 1442-9071 [Electronic] Australia
• PMID: 23145528 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

Chemical References

• Cross-Linking Reagents
• Photosensitizing Agents
• Collagen
• Riboflavin

Topics

• Adolescent
• Adult
• Collagen (metabolism)
• Corneal Pachymetry
• Corneal Stroma (metabolism)
• Cross-Linking Reagents (therapeutic use)
• Disease Progression
• Female
• Humans
• Keratoconus (diagnosis, drug therapy, metabolism)
• Longitudinal Studies
• Male
• Photosensitizing Agents (therapeutic use)
• Prospective Studies
• Refraction, Ocular (physiology)
• Riboflavin (therapeutic use)
• Ultraviolet Rays
• Visual Acuity (physiology)
• Young Adult