Clinical Results of Riboflavin and Ultraviolet-A-induced Corneal Crosslinking for Progressive Keratoconus in Korean Patients

Pyung Lee; Kyung Hyun Jin

doi:10.3341/jkos.2011.52.1.23

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Lee and Jin: Clinical Results of Riboflavin and Ultraviolet-A-induced Corneal Crosslinking for Progressive Keratoconus in Korean Patients

Original Article

J Korean Ophthalmol Soc 2011;52(1):23-28.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.1.23

Clinical Results of Riboflavin and Ultraviolet-A-induced Corneal Crosslinking for Progressive Keratoconus in Korean Patients

Pyung Lee, MD, Kyung Hyun Jin, MD, PhD

Department of Ophthalmology, KyungHee University School of Medicine, Seoul, Korea

Address reprint requests to Kyung Hyun Jin, MD, PhD Department of Ophthalmology, KyungHee University Medical Center #1 Hoegi-dong Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: khjinmd@khmc.or.kr

Received 5 July 2010 Revised 17 September 2010 Accepted 9 December 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the clinical results of 10 progressive keratoconic eyes in Korean patients treated by corneal cross-linking and compare the progression of keratoconus in the fellow eyes.

Methods

This present retrospective case series was comprised of 10 progressive keratoconic eyes (10 patients) that had corneal cross-linking. Patients were examined before corneal cross-linking as well as 1, 3, 6, 9, and 12 months postoperatively. The main outcome measures were best corrected visual acuity, maximum keratometry, mean keratometry, corneal thickness, corneal astigmatism and endothelial cell count.

Results

The best corrected visual acuity (logMAR) improved from 0.60 ± 0.39 to 0.52 ± 0.38 at 12 months postoperatively. The maximum keratometry decreased from 62.39 ± 8.82 D preoperatively to 60.21 ± 9.21 D at 12 months postoperatively and the mean keratometry decreased from 51.59 ± 5.86 D to 50.04 ± 6.21 D at 12 months. In addition, the corneal thickness (at the thinnest area) decreased from 433.60 ± 44.31 μ m to 403.40 ± 38.95 μ m at 12 months. There was no statistically significant difference between the preoperative and 12 months postoperative endothelial cell count (p = 0.731).

Conclusions

This present 1-year follow-up study of Korean keratoconus patients showed corneal cross-linking appeared to be effective in the stabilizing progression of keratoconus and improving best corrective visual acuity and keratometry.

Keywords: Corneal cross-linking, Keratoconus, Riboflavin, UV-A

References

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Figure 1.

(A) Mean change in maximum keratometry between baseline and 3, 6, 9, and 12 months for treatment and control groups. (B) Mean change in mean keratometry between baseline and 3, 6, 9, and 12 months for treatment and control groups. (C) Mean change in corneal astigmatism between baseline and 3, 6, 9, and 12 months for treatment and control groups. (D) Mean change in BCVA between baseline and 3, 6, 9, and 12 months for treatment and control groups. (E) Mean change in apex corneal thickness between baseline and 3, 6, 9, and 12 months for treatment and control groups (At each time point, the bar represents the mean change from baseline and the p value is calculated using independent samples t-test between control and treatment group).

Table 1.

Pre-and postoperative data after corneal cross-linking at different time points

Measurement (mean ± SD)	Pre-CCL^†	Postoperative follow-up (months)
Measurement (mean ± SD)	Pre-CCL^†	1	3	6	12
BCVA^* (logMAR)	0.60 ± 0.39	0.60 ± 0.40	0.54 ± 0.34	0.50 ± 0.30	0.52 ± 0.38
Maximum keratometry (D)	62.39 ± 8.82	63.39 ± 10.04	61.85 ± 9.98	61.34 ± 9.40	60.21 ± 9.21
Mean keratometry (D)	51.59 ± 5.86	51.81 ± 6.34	50.93 ± 6.45	50.68 ± 6.53	50.40 ± 6.21
Thinnest corneal thickness (μ m)	433.60 ± 44.31	403.00 ± 40.63	393.70 ± 27.05	396.80 ± 31.68	403.40 ± 38.95
Apex corneal thickness (μ m)	444.90 ± 53.06	413.50 ± 53.07	408.50 ± 56.53	408.70 ± 51.17	422.70 ± 42.85
Corneal astigmatism (D)	6.92 ± 1.53	6.80 ± 2.63	7.09 ± 2.92	6.65 ± 2.27	6.22 ± 2.11

^* Best corrected visual acuity

^† Corneal cross-linking.

Table 2.

Comparison of parameters measured preoperatively and at 12 months in the cross-linked (treated) eyes and control fellow eyes

Measurement (mean)	Treatment eyes			Non-treated eyes (control)
Measurement (mean)	Pre	12 M	p-value^†	Pre	12 M	p-value^†
BCVA (logMAR)^*	0.60	0.52	0.145	0.18	0.19	0.555
Maximum keratometry (D)	62.39	60.21	0.087	53.14	54.05	0.189
Mean Keratometry (D)	51.59	50.40	0.048	46.96	47.61	0.041
Thinnest Corneal thickness (μ m)	433.60	403.40	0.002	455.60	449.10	0.116
Apex Corneal thickness (μ m)	444.90	422.70	0.126	483.70	481.60	0.431
Corneal astigmatism (D)	6.92	6.22	0.089	2.77	3.53	0.002

^* Best corrected visual acuity

^† Paired sample t-test between pre-treatment and 12-month follow-up.

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