Visual and Refractive Long-Term Outcomes Following Standard Cross-Linking in Progressive Keratoconus Management

• Main Authors: Iqbal M, Elmassry A, Badawi AE, Gharieb HM, Said OM
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-12-01
• Series: Clinical Ophthalmology
• Subjects: keratoconus; standard cross-linking; eye rubbing; ectasia; kc progression
• Online Access: https://www.dovepress.com/visual-and-refractive-long-term-outcomes-following-standard-cross-link-peer-reviewed-article-OPTH

Mohammed Iqbal,1 Ahmed Elmassry,2 Amani E Badawi,3 Hesham M Gharieb,4 Omar M Said5 1Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt; 2Department of Ophthalmology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 3Department of Ophthalmology, Faculty of Medicine, Mansoura University, Mansoura, Egypt; 4Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Department of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, EgyptCorrespondence: Omar M SaidDepartment of Ophthalmology, Faculty of Medicine, Fayoum University, Fayoum, EgyptTel [phone]Email [e-mail]: To analyze the effectiveness and stability of the refractive, topographic and visual outcomes of the standard cross-linking (SCXL) in keratoconus (KC) management.Patients and methods: This study was designed as a retrospective non-comparative study that included 28 KC patients (n=49 eyes) who performed SCXL as a single procedure to treat KC and completed five-year follow-up period. The topographic, refractive and visual data were recorded preoperatively and at 12, 24, 36 and 60 months postoperatively.Results: Forty eyes (81.6%) showed achieved postoperative spherical equivalent (SE) refraction better than the attempted refraction. Ten eyes (20.4%) improved by<1 D, 23 eyes (46.9%) improved from 1 D to <2 D and 7 eyes (14.3%) improved by ≥2 D. Both uncorrected distant visual acuity (UDVA) and corrected distant visual acuity (CDVA) showed statistically significant improvement from preoperative 1.34±0.29 (mean±SD) and 0.74±0.23 LogMAR to postoperative 0.99±0.32 and 0.50±0.22 LogMAR (P<0.0001) respectively. Both Kmax and SE refraction showed statistically significant and stable improvement from preoperative 51.95±1.90 and −7.90 ±3.14 D to postoperative 50.19±1.96 and −6.35±2.49 D (P<0.0001) respectively. Two eyes (4%)showed KC progression at the end of 5th follow-up year. Conclusion: SCXL had good effectiveness and stability that halted KC progression over 5-year follow-up period. It had also unexpected improvement in the KC refractive components mainly the spherical and SE components. Keywords: keratoconus, standard cross-linking, eye rubbing, ectasia, KC progression