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Published on: November 12, 2015

Collagen cross-linking for advanced progressive keratoconus.

Anders Ivarsen1, Jesper Hjortdal

  • 1Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark. ai@dadlnet.dk

Cornea
|March 2, 2013
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Summary
This summary is machine-generated.

Corneal collagen cross-linking (CXL) effectively halts progressive keratoconus in advanced cases (maxK ≥ 55 D). Most patients experienced stopped progression, preserving visual acuity and potentially delaying keratoplasty.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Vision Science

Background:

  • Keratoconus is a progressive corneal ectasia leading to vision loss.
  • Corneal collagen cross-linking (CXL) is established for halting keratoconus progression.
  • Eyes with high maximal keratometry (maxK) > 55-58 D may have higher CXL failure rates.

Purpose of the Study:

  • To evaluate the efficacy of CXL in treating progressive keratoconus in eyes with maxK of 55 D or higher.
  • To assess the safety and outcomes of CXL in advanced keratoconus cases.

Main Methods:

  • Retrospective analysis of 28 eyes from 22 patients with progressive keratoconus and preoperative maxK ≥ 55 D.
  • Corneal collagen cross-linking (CXL) was performed on all participants.
  • Follow-up included corrected distance visual acuity (CDVA) and Pentacam tomography, with a mean follow-up of 22 months.

Main Results:

  • Average preoperative maxK was 61.2 ± 3.7 D, decreasing to 59.5 ± 3.7 D post-CXL.
  • Keratoconus progression halted in 27 of 28 eyes.
  • 14 eyes showed a maxK improvement (>2.0 D decrease), while 1 eye showed progression (>2.0 D increase). Average CDVA remained stable, with improvements in 11 eyes and unexplained losses in 2.

Conclusions:

  • CXL is effective in preventing further progression of advanced progressive keratoconus in most cases (27/28 eyes).
  • CXL should be considered for advanced keratoconus to preserve visual acuity or supplement other treatments, potentially delaying or avoiding keratoplasty.