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Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Complication and failure rates after corneal crosslinking.
Tobias Koller1, Michael Mrochen, Theo Seiler
1From Institut für Refraktive und Ophthalmo-Chirurgie, Zürich, Switzerland.
Journal of Cataract and Refractive Surgery
|July 28, 2009
Summary
Corneal crosslinking (CXL) for keratectasia has a low complication rate. Adjusting patient age and keratometry can further reduce complications and improve CXL success rates.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Vision Science
Background:
- Progressive keratectasia poses a risk to vision.
- Corneal crosslinking (CXL) is a treatment option for progressive keratectasia.
- Evaluating CXL complication rates is crucial for patient safety and treatment efficacy.
Purpose of the Study:
- To determine the complication rate of corneal crosslinking (CXL) in primary keratectasia.
- To identify risk factors associated with CXL complications and treatment failure.
- To propose recommendations for minimizing CXL-related complications and failures.
Main Methods:
- Prospective study of 117 eyes with progressive keratectasia undergoing standard CXL.
- Preoperative and 12-month postoperative assessments included visual acuity, slitlamp, tonometry, and Scheimpflug imaging.
- Statistical analysis identified risk factors for complications and failure.
Main Results:
- The overall complication rate was 2.9%, with a CXL failure rate of 7.6%.
- Risk factors for complications included age over 35 and preoperative CDVA better than 20/25.
- High preoperative keratometry was a risk factor for failure; sterile infiltrates and scars were observed.
Conclusions:
- Modifying CXL inclusion criteria can significantly decrease complication and failure rates.
- Restricting CXL to patients younger than 35 may lower complication rates to 1%.
- Limiting preoperative maximum keratometry to <58.00 D may reduce failure rates to <3%.
