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Two registry studies show reduction in transplantation procedures after introduction of cross-linking
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MAASTRICHT, Netherlands — Two registry studies carried out in Europe showed significant decreases in corneal transplantation procedures since the introduction of corneal cross-linking as a treatment for keratoconus.
The first was a nationwide study that involved the entire 17 million people population in the Netherlands. The second involved the 3 million inhabitants of Oslo, Norway, accounting for half of the country’s population. In both studies, a period of 2 to 3 years before the introduction of cross-linking was compared with a period of 7 to 8 years after cross-linking was adopted.
Liv Drolsum
“Before CXL, the Dutch study reported 270 transplantations for keratoconus over 3 years, and 7 years later this number was reduced to 202, a significant 25% reduction. In our study in Oslo, transplantations were 55 before and 26 8 years after, accounting for a 50% reduction,” Liv Drolsum, MD, PhD, said at the European Society of Cataract and Refractive Surgeons winter meeting.
She pointed out, however, that other factors besides cross-linking may be involved. In both studies, there was a trend toward more advanced keratoconus in the second period, which may be related to changes in the indications for transplantation.
“There are also other treatment modalities that may have been adopted, such as Intacs (Addition Technology), [clear lens exchange] with toric IOLs, and also new contact lens materials and design, delaying or even preventing the need for transplantation,” Drolsum said.
Smaller studies published in other countries showed contrasting data, in some cases confirming but in other cases contradicting the findings of the Dutch and Norwegian registry studies by showing a stable or even increased rate of transplantation.
“We can see from our clinic that many patients only present when the second eye starts getting worse. We must work on awareness and prevention,” Drolsum said.
She said more data are needed over a longer period of time because a time frame of 7 to 8 years may not be enough for cross-linking to have an impact on the transplantation rate. – by Michela Cimberle
Reference:
Drolsum L. The impact of cross-linking on corneal transplantation. European Society of Cataract and Refractive Surgeons winter meeting; Feb. 10-12, 2017; Maastricht, Netherlands.
Disclosure: Drolsum reports no relevant financial disclosures.