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Risk factors for progression following corneal collagen crosslinking in keratoconus

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Abstract

Purpose

To assess risk factors for progression following corneal collagen crosslinking (CXL) in eyes with keratoconus.

Methods

Charts of patients who developed progression following conventional CXL treatment (Dresden protocol) were retrospectively evaluated in two centers (Center 1 and Center 2). 871 eyes of a total of 676 patients were analyzed. Progression was defined as > 1 diopter (D) increase in maximum keratometry (Kmax) readings compared to baseline.

Results

Progression was noted in 20 eyes of 20 patients (progression rate 3%). The mean age of the patients was 17.65 ± 5.76 (11–34)-years-old, and the mean follow-up following CXL was 36.70 ± 25.72 (12–84)-months-old. The gender distribution was 13 (65%) females and seven (35%) males. Four eyes (20%) had mild, 13 eyes (65%) had moderate, and three eyes (15%) had severe keratoconus at baseline. Fifteen eyes (75%) had allergic conjunctivitis, and 20 eyes (100%) reported eye-rubbing. Cone location was central in 17 (85%) eyes, and peripheral in 3 (15%) eyes. A mean of 2.21 ± 1.30 D (1.00–5.30 D) steepening was determined at Kmax 6 to 82 months following CXL treatment.

Conclusions

Progression rate was found to be higher in the patients under the age of 17 years, female gender, allergic conjunctivitis, high preoperative Kmax (> 57 D), thin corneas (< 430 µm). The majority of progressive patients were central cone and moderate keratoconus.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey

    Ayhan Sağlık

  2. Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Gökçen Özcan & Ömür Uçakhan

Authors
  1. Ayhan Sağlık
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  2. Gökçen Özcan
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  3. Ömür Uçakhan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by AS, GÖ, and ÖU. The first draft of the manuscript was written by AS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ayhan Sağlık.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

Approval for the study was given by the local ethics committee (Ethics acceptance number: HRU/20.19.2), and all transactions were carried out in accordance with the Declaration of HELSINKI. Written informed consent was obtained from all patients before the study.

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Sağlık, A., Özcan, G. & Uçakhan, Ö. Risk factors for progression following corneal collagen crosslinking in keratoconus. Int Ophthalmol 41, 3443–3449 (2021). https://doi.org/10.1007/s10792-021-01908-9

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  • DOI: https://doi.org/10.1007/s10792-021-01908-9

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