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Corneal cross-linking improves visual acuity, refraction in keratoconic eyes
Corneal collagen cross-linking improved visual acuity and reduced total aberrations in young patients with progressive keratoconus, a study found.
“Progression of the disease can be dramatically faster in children, with increasing visual impairment, inability to obtain satisfactory correction with spectacles or soft contact lenses, and intolerance to rigid gas permeable contact lenses,” the study authors said.
The prospective, interventional case series included 40 eyes of patients younger than 18 years with progressive keratoconus and corneal thickness of at least 400 μm at the thinnest point. Mean patient age was 14.2 years.
All eyes underwent corneal cross-linking with riboflavin and ultraviolet-A irradiation.
Investigators evaluated logMAR uncorrected visual acuity and best corrected visual acuity, sphere, cylinder, topography, aberrometry, pachymetry and endothelial cell counts at baseline and at 1, 3, 6, 12 and 24 months after treatment.
Mean baseline logMAR UCVA was 0.79, and mean baseline BCVA was 0.39. At 2 years, mean UCVA was 0.58 and mean BCVA was 0.2. Visual acuity gains were statistically significant at all follow-up points (P < .05).
Mean spherical equivalent refraction decreased by 1.57 D at 25 months; the decrease was statistically significant (P = .02).
Mean average corneal power was 49.69 D at baseline and 48.9 D at 24 months; the change was statistically significant (P = .03).
“These results demonstrate a flattening effect of [corneal cross-linking] on the keratoconic cornea,” the study authors said.
For a 3-mm pupil, results showed significant reductions in total, corneal, higher-order and astigmatic wavefront aberrations at 24 months (P < .05). Endothelial cell counts changed insignificantly, the authors said.