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Corneal cross-linking for treatment of keratoconus relapse in post-keratoplasty eyes

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Abstract

Purpose

Keratoconus relapse after penetrating keratoplasty is a rare condition that may result in severe visual deterioration and corneal graft thinning. Therefore, treatment to stabilize the cornea should be considered. The purpose of this study was to evaluate the safety and efficacy of Corneal Cross-Linking (CXL) in eyes with relapse of keratoconus after penetrating keratoplasty for keratoconus.

Materials and methods

A retrospective review of eyes that developed keratoconus relapse following a penetrating keratoplasty and treated with CXL. The main outcome measures were change in maximal keratometry (Kmax), best-corrected distance visual acuity (BCVA), thinnest corneal thickness (TCT) and central corneal thickness (CCT), and complications.

Results

We identified 10 consecutive eyes of 9 patients. Preoperative median BCVA before the CXL and 1 year after the CXL procedure remained stable (p = 0.68). The median (IQR) of Kmax improved from 63.2 (24.9) D before the CXL procedure to 62.2 (27.1) D at 1 year postoperatively (P = 0.028). Median TCT and CCT also remained with no significant change 1 year after CXL. No complications were noted following the procedure.

Conclusion

CXL in eyes with keratoconus relapse after keratoplasty is a safe and effective procedure enabling not only visual stabilization but also might bring keratometry improvement. Routine follow-up after keratoplasty should be performed for early detection of keratoconus relapse and CXL is timely advised when such a relapse is documented.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Noa Kapelushnik and Noa Avni-Zauberman these authors contributed equally to this work.

Authors and Affiliations

  1. Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel

    Noa Kapelushnik, Noa Avni-Zauberman, Yoav Berger, Orit Ezra Nimni, Amir Abd-Elkader & Irina S. Barequet

  2. Department of Ophthalmology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany

    Robert Herber & Frederik Raiskup

Authors
  1. Noa Kapelushnik
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  2. Noa Avni-Zauberman
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  3. Robert Herber
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Contributions

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

Corresponding author

Correspondence to Irina S. Barequet.

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Conflict of interests

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study was approved by Sheba medical center’s institutional review board and adheres to the tenets of the Declaration of Helsinki. Informed consent was waived for this retrospective analysis.

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Kapelushnik, N., Avni-Zauberman, N., Herber, R. et al. Corneal cross-linking for treatment of keratoconus relapse in post-keratoplasty eyes. Int Ophthalmol 43, 4027–4034 (2023). https://doi.org/10.1007/s10792-023-02807-x

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  • DOI: https://doi.org/10.1007/s10792-023-02807-x

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