Outcomes of Corneal Collagen Cross-linking in Keratoconus

Abstract

Study title: Outcomes of corneal collagen crosslinking in keratoconus at Eagle Eye Laser Centre Study objective: To determine the outcomes of cross-linking in keratoconus patients at Eagle Eye Laser Centre, Nairobi from January 1st 2017 to June 30th 2018. Methodology: This study was a retrospective case series on the outcomes of corneal collagen crosslinking from 174 eyes that had undergone CXL at EELC for keratoconus and evaluated at 1 week, 1 month, 3 months, 6 months and 1 year. Postoperative results were categorised in terms of visual outcomes, topographic outcomes, complications and associations of the outcomes. Results Our study found that the UCVA at 3 months had improvement in 41.7% by 2.1 lines, at 6 months in 37.9% by 2.5 lines and at 12months in 45.5% by 2.2 lines. At 6 months Kmean flattening was seen in 15.2%, and remained the same in 75.8%, at 12 months Kmean flattening was seen in 10.7% and remained the same in 75.0%. At 6 months Kmax flattening was seen in 24.2% and remained the same in 48.5%, at 12 months Kmax flattening was seen in 28.6% and remained the same in 53.6%. The complication rate was 13.2% with corneal haze the most common finding postoperatively which resolved after 3 months. Progression was seen in 15.2% at 6 months and 14.3% at 12 months with no factors found significantly associated at 6 or 12 months. Conclusion CXL was shown to effectively halt the progression of keratoconus in 84.8% of eyes at 6 months and 85.7% at 12 months. It was also shown to improve or stabilise UCVA and BCVA in at least 50% of patients. The procedure had few complications all of which resolved after 3 months postoperatively. Even for eyes with TCT < 400μm CXL was found to be safe and effective.