Risk factors for keratoconus progression after treatment by accelerated cross-linking (A-CXL): A prospective 24-month...

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Keratoconus is a progressive corneal ectasia leading to vision impairment.
• Accelerated corneal cross-linking (A-CXL) is a treatment aimed at halting keratoconus progression.
• Predicting treatment response in keratoconus is crucial for patient management.

Purpose of the Study:

• To identify factors predicting treatment success after A-CXL for progressive keratoconus.
• To evaluate clinical and topographic outcomes two years post-A-CXL.

Main Methods:

• A prospective, interventional study included 82 eyes of 60 patients with progressive keratoconus.
• Patients underwent A-CXL with epithelial debridement.
• Clinical and topographic parameters were assessed at baseline and 24 months post-procedure.

Main Results:

• 17.1% of eyes showed progression (non-responders) after A-CXL.
• Non-responders were younger, had lower initial visual acuity, higher maximal posterior curvature, and more optical aberrations.
• Younger age (P=0.04) and higher posterior curvature (P=0.03) were associated with non-response.

Conclusions:

• Eyes with aggressive keratoconus (younger patients, higher curvature, more aberrations) have a higher risk of A-CXL non-response.
• Patients with these characteristics should be counseled about potential treatment failure and the need for further interventions.
• A-CXL is effective in stabilizing keratoconus in most patients.