Corneal Collagen Crosslinking Delivers Sustained Severity Improvements in Pediatric Keratoconus

Corneal collagen crosslinking (CXL) provides sustained benefits over a 5-year period in patients with pediatric keratoconus, according to research results presented at the American Academy of Ophthalmology 2020 annual meeting, held virtually November 13 to 15, 2020. 

Researchers sought to examine long-term CXL outcomes via the Dresden Protocol: isotonic 0.1% riboflavin-5-phosphate with 20% dextran. A time-sequence comparison was conducted of baseline, 2-year, and 5-year visual, tomographic, and biomechanical parameters. The study population included 66 eyes from 63 patients who were at least 16 years (mean age, 12.94; 87% male). 

Mean corrected distance visual acuity was 0.485, 0.367, and 0.370 logMAR at baseline, 2, and 5 years respectively (P =.001). Mean spherical and cylindrical errors were -3.99 ± 3.81, -2.92 ± 3.08, and -3.006 ± 3.04 and -2.96 ± 2.32 D, -2.64 ± 2.13, and -2.62 ± 1.98 at the same timepoints (P =.003). 

Researchers also measured mean pachymetry, the results of which were 456.92 μm, 404.4 μm, and 389.67 μm at baseline, 2, and 5 years, respectively (P =.000). Kmax, ARTMax, and K mean posterior were also measured: 59.27, 58.09, and 57.75 (P =.000); 177.5, 122.4, and 101.97; and -7.4, -7.5, and -7.4, respectively. Finally, corneal resistance factors were measured as 6.38 ± 1.89 and 6.77 ± 1.66, and corneal hysteresis was measured as 7.6 ± 1.79 and 8.06 ± 1.72. 

“The benefits of CXL show sustained improvement in severity of keratoconus even after 5 years in pediatric eyes,” the researchers concluded. 

Reference

Choudhary Jr. T, Gupta A, Kulshrestha A, Thakur A. Pediatric CXL: Five-year outcomes of a large case series. Presented at: American Academy of Ophthalmology 2020 Annual Meeting; November 13-15, 2020. Abstract PO071.