Clinical Outcomes of Corneal CXL in Advanced Keratoconus, Stages 3 and 4: 4-Year Follow-up
Purpose
To analyze the four-year outcomes of standard corneal collagen crosslinking (CXL) in patients with advanced keratoconus (KC), including stages 3 and 4.
Methods
Forty eyes with advanced KC were submitted to CXL treatment. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal topography, pachymetry and endothelial cell count were evaluated at baseline, 12, 24, 36 and at 48 months after surgery.
Results
Mean patient age was 22.5 years (range, 15-36.9 years). Mean follow up was 4.9 years (range, 4-6.1 years). Apical Keratometry and ultrasonic pachymetry showed a statistically significant change during follow-up (p < 0.05), while UCVA, BCVA and mean K did not show statistically significant change during the follow-up period (p > 0.05). Apical K showed statistically significant reduction in 4 years (p = 0.037), and the ultrasonic pachymetry decreased from preoperative to 1 year and 4 years after surgery (p = 0.029 and p < 0.001 respectively). Postoperative complications included apical keratitis (1 eye) and mild haze (4 eyes) that did not impact on BCVA or lines of vision after 1 year.
Conclusion
After a four-year follow-up with standard CXL treatment, visual acuity and corneal curvature seems to remain stable in the eyes with advanced KC. CXL in advanced KC seems to be effective in retarding the disease progression and presents a low rate of complications.