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Preop vision a factor in BCVA change after cross-linking
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SAN DIEGO — Corneal collagen cross-linking thwarted the progression of keratoconus and corneal ectasia in a majority of patients, and corneal flattening was sustained after 1 year, according to a study presented here.
“We can say that cross-linking in most of the patients was very effective, that preop BCVA was a predictive factor for the change in BCVA in time, and also that the preop value of the average K was a predictive factor for change of keratometry in time,” Isabelle E.Y. Saelens, MD, said at the World Cornea Congress.
The retrospective study included 273 eyes that were treated for progressive keratoconus with the epithelium-off technique. Mean follow-up was 22 months.
Isabelle E.Y. Saelens, MD
Keratoconus was halted in 88.5% of cases.
There was no significant improvement in uncorrected visual acuity. However, best corrected visual acuity improved significantly at 1 year and remained stable thereafter. At 1 year, 83% of patients gained one line or more.
Thirteen eyes lost two or more lines of BCVA after 1 year, which Saelens called “quite high.”
Preoperative BCVA of 0.8 or more was a risk factor for losing lines.
“Now, we are a little bit more cautious to treat those patients who had very good vision before,” Saelens said.
Eyes with worse preoperative BCVA had more improvement after treatment.
Steep K values and the average K reading decreased.
Higher preoperative mean K values were associated with greater corneal flattening.
Endothelial cell density decreased 0.5%. Corneal thickness remained stable.
After 1 year, 11.5% of patients had more than 1 D of progression, and 1.09% of patients required deep anterior lamellar keratoplasty, Saelens said. – by Matt Hasson
Disclosure: Saelens reports no relevant financial disclosures.