Effective corneal collagen crosslinking in advanced cases of progressive keratoconus.

PURPOSE: To evaluate the 1-year results of corneal collagen crosslinking (CXL) in mild to moderate cases and advanced cases of progressive keratoconus.

SETTING

Department of Ophthalmology, University Medical Center Utrecht, the Netherlands.

DESIGN

Retrospective cohort study.

METHODS

Eyes with progressive keratoconus had CXL between January 2010 and April 2011. Patients were divided into 2 subgroups as follows: Group 1, mild to moderate keratoconus with a preoperative maximum keratometry (K) of less than 58.0 diopters (D), and Group 2, advanced keratoconus with a maximum K of 58.0 D or more. Visual acuity, refraction, and elevation-based topography were evaluated at baseline and 12 months after CXL.

RESULTS

The study comprised 53 eyes of 42 patients. In the overall group, progression was halted in 48 eyes (91%). The CXL-induced corneal flattening occurred in 11 (42%) of 26 eyes in Group 1 and 20 (74%) of 27 eyes in Group 2. Five of 7 keratoconus indices improved 12 months after CXL. The failure rate was comparable in the subgroups (3 eyes in Group 1, 2 eyes in Group 2). No major complications occurred in either subgroup.

CONCLUSIONS

Stabilization after CXL was achieved in mild to moderate cases and advanced cases of progressive keratoconus. The amount of failure was comparable in the 2 subgroups. The CXL-induced flattening was more pronounced in the advanced subgroup.