Long-term follow-up of repeated corneal cross-linking for progressive keratoconus in young patients

Acompanhamento a longo prazo do retratamento com cross-linking corneano para ceratocone em progressão em pacientes jovens

ABSTRACT

Objective:

To evaluate the long-term safety and efficacy of repeated corneal cross-linking in eyes of children and adolescents with progressive keratoconus.

Methods:

This retrospective study included nine eyes of nine consecutive patients with progressive keratoconus who underwent repeated corneal cross-linking 3.9 (range of 1.6 to 5.6) years after a primary one. All patients were followed for a mean period of 9.11 (range of 6 to 11) years after first treatment and 5.44 (range of 4 to 9) years, after corneal cross-linking retreatment.

Results:

Nine eyes of nine patients (six male) with progressive keratoconus underwent primary corneal cross-linking from 2009 to 2011. Despite the stability achieved with the epi-off corneal cross-linking, keratoconus continued to progress after some time. Mean time to documented evidence of keratoconus progression after primary corneal cross-linking was 3.9 (range of 1.6 to 5.6) years. All eyes were retreated as soon as progression was noted. At the last follow-up visit, 5.44 (range of 4 to 9) years after repeated corneal cross-linking, there was a significant decrease of 2.02 D in mean maximum topographic K-value (p = 0.045) and 1.95D in mean topographic K-value (p = 0.007).

Conclusion:

Repeated corneal cross-linking seems to be a safe and effective procedure to halt keratoconus progression after a primary corneal cross-linking failure.

Keywords:
Keratoconus; Child; Adolescent; Corneal cross-linking; Retreatment