Treatment of Keratoconus with Corneal Cross-linking – Results and Complications in 2 Years Follow-up
Authors:
E. Strmeňová 1,2; E. Vlková 1; L. Michalcová 1; V. Trnková 1; D. Dvořáková 1; M. Goutaib 1; J. Němec 1; A. Gerinec 2
Authors‘ workplace:
Oční klinika LFMU a FN Brno, prednostka prof. MUDr. Eva Vlková, CSc.
1; Klinika Detskej oftalmológie, DFNsP
Bratislava, prednosta prof. MUDr. Anton
Gerinec, CSc.
2
Published in:
Čes. a slov. Oftal., 71, 2015, No. 3, p. 158-168
Category:
Original Article
Overview
Objective:
The objective of the study was to assessment of changes of monitored parameters after CXL. Incidence of complications were assessed in the whole group and in groups of patients divided according to the selected criteria. Evaluated parameters were also relations between them and in time.
Methods:
The 86 eyes of patients with progressive keratoconus who underwent CXL according to the Dresden protocol in the years 2007-2009 at the Ophthalmic clinic FN Brno Bohunice were included in this study.
Results:
There was observed significant increase of BCVA (letters – before CXL 42,30 ± 10,35, 1st year after CXL (1Y) 44,68 ± 10,04, p < 0,01, 2nd year after CXL (2Y) 44,44 ± 10,57, p < 0,01) and SE (-5,95 ± 3,98D, -5,27 ± 3,84D, p < 0,01, -4,94 ± 3,68D, p < 0,01), and decrease of maximum curvature of the cornea (MAX – before CXL 50,39 ± 4,17D, 1Y 49,46 ± 4,13D, p < 0,01, 2Y 49,42 ± 4,14D, p < 0,01). Change of ultrasound CCT, polymegatisms, pleomorfisms and corneal endothelial cell density was not significant.
The value of MAX is the most important parameter in estimating the effect of CXL.
The highest incidence of corneal opacity after CXL was observed in the eyes of patients with III. stage of keratoconus over 40 years old, carrying hard contact lenses and with biomikroskopic symptom of keratoconus on the cornea.
We found that corneal thickness measurement with Orbscan II and the mesurement of IOP with noncontact method is incorrect by patients after CXL.
Conclusion:
Corneal cross-linking of the cornea is safe and effective procedure of stopping the progression of keratoconus in 97% of eyes in the period up to 2 years after CXL.
Key words:
keratoconus, corneal cross-linking, riboflavin, UVA irradiation, complications
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Czech and Slovak Ophthalmology
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