A RETROSPECTIVE STUDY OF VISUAL OUTCOME OF PATIENTS WITH PROGRESSIVE KERATOCONUS AFTER CORNEAL COLLAGEN CROSSLINKING

Tara Mahmood Hassana and Ballga Barzan Ahmed b




a Department of Surgery, College of Medicine, University of Sulaimani. 
b Directorate of Health-Sulaimani.


Submitted: 10/3/2018; Accepted: 11/9/2018; Published 21/12/2018
ABSTRACT


Background 

Corneal collagen cross-linking is a new treatment modality aimed at increasing the biomechanical stability of the cornea through the application of riboflavin and UVA-induced collagen cross-linking it seems to be possible to stop the progression of keratoconus (a progressive, non-inflammatory corneal thinning disorder). 


Objectives 

To assess the effectiveness of corneal collagen cross-linking in stabilizing progression of keratoconus and visual effects in patients with progressive disease.


Patients and Methods

Fifty nine eyes of thirty-five patients with progressive keratoconus (19 females and 16 males) who underwent corneal collagen crosslinking between Dec. 2013 and Sep. 2014 were included in a retrospective non-controlled experimental study. The data collected in Tooe Maleek private hospital and Shahid-Aso Eye Teaching Hospital, in which recorded pre-procedure uncorrected, and best spectacle-corrected visual acuity using Snellen acuity chart-decimal notation, autorefraction (by autorefractometer) and topography findings (CCT and mean K-reading using OCULUS-PENTACAM) were taken and patients examined after the procedure in a period between 6-12 months and then pre and post crosslinking findings were compared. The data were collected between January to July 2015.


Results
The age of all patients were under 30 years. Females more commonly affected than males. The most common association or risk factor was continuous rubbing of the eyes. After corneal cross-linking, there was a statistically significant improvement in uncorrected, best spectacle-corrected visual acuity, decreased central corneal thickness (CCT) and mean keratometric reading (K reading). While each of myopic spherical equivalent and cylinder refractive error showed no statistically significant difference before and after the procedure (Stabilized). 

Conclusion
The corneal collagen crosslinking with riboflavin and UV-A irradiation was proved to be effective in halting the keratoconus progression.


KEYWORDS

Keratoconus, Crosslinking, Keratometric, Riboflavin, UV-A irradiation.