PURPOSE: To assess topographical changes in patients with keratoconus while awaiting corneal cross-linking (CXL) treatment. METHODS: In this prospective, double-center, observational clinical study, patients with keratoconus were enrolled. Progression was defined as a change in the curvature within the cone area of at least 1.00 diopter (D) on tangential map and a thinning of 20 mu m at the thinnest point after measurements taken at least 3 months apart. Morphological parameters were assessed at baseline (day of listing for CXL) and on the day of CXL treatment, including slit-lamp biomicroscopy, keratometry (maximum, minimum, and mean), and thinnest corneal thickness using corneal tomography (Pentacam; Oculus Optikgerate GmbH, Wetzlar, Germany). RESULTS: One hundred four eyes of 104 patients were included. The waiting time was 84.8 +/- 62.9 days. Twenty-five percent of patients showed evidence of progression while waiting for treatment. Patients who progressed while waiting for treatment were younger (22.2 +/- 6.79 years) compared to those who did not show evidence of progression (25.4 +/- 5.62 years) (P = .02). Stratification by age groups showed a significant worsening of maximum keratometry of 1.18 +/- 1.37 D in patients younger than 18 years compared to those 18 to 26 years of age and those older than 26 years (P = .002 and .042, respectively). The multivariate model confirmed that the progression steepening of the maximum keratometry while waiting for treatment was associated with age (P = .028). CONCLUSIONS: The results suggest that stratification of waiting time according to the patient's age is required to reduce the risk of further progression of keratoconus.

Progression of Keratoconus in Patients While Awaiting Corneal Cross-linking: A Prospective Clinical Study

Vinciguerra P;
2018-01-01

Abstract

PURPOSE: To assess topographical changes in patients with keratoconus while awaiting corneal cross-linking (CXL) treatment. METHODS: In this prospective, double-center, observational clinical study, patients with keratoconus were enrolled. Progression was defined as a change in the curvature within the cone area of at least 1.00 diopter (D) on tangential map and a thinning of 20 mu m at the thinnest point after measurements taken at least 3 months apart. Morphological parameters were assessed at baseline (day of listing for CXL) and on the day of CXL treatment, including slit-lamp biomicroscopy, keratometry (maximum, minimum, and mean), and thinnest corneal thickness using corneal tomography (Pentacam; Oculus Optikgerate GmbH, Wetzlar, Germany). RESULTS: One hundred four eyes of 104 patients were included. The waiting time was 84.8 +/- 62.9 days. Twenty-five percent of patients showed evidence of progression while waiting for treatment. Patients who progressed while waiting for treatment were younger (22.2 +/- 6.79 years) compared to those who did not show evidence of progression (25.4 +/- 5.62 years) (P = .02). Stratification by age groups showed a significant worsening of maximum keratometry of 1.18 +/- 1.37 D in patients younger than 18 years compared to those 18 to 26 years of age and those older than 26 years (P = .002 and .042, respectively). The multivariate model confirmed that the progression steepening of the maximum keratometry while waiting for treatment was associated with age (P = .028). CONCLUSIONS: The results suggest that stratification of waiting time according to the patient's age is required to reduce the risk of further progression of keratoconus.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11699/7096
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