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Research Article
elias jarade
beirut eye and ENT specialist hospital
Corresponding Author
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PURPOSE: To report the response of keratoconus(KC) and post-LASIK ectasia (referred as ‘’ectasia’’) to the corneal crosslinking(CXL) and to compare the rate of progression between KC and ectasia at 3 years.
METHODS: Retrospective cohort study of patients undergoing CXL for either KC or ectasia. 54 eyes(31 patients) with ectasia and 111 eyes(67 patients) with KC were included in the study. Corrected distance Visual acuities(CDVA), refraction, keratometry(K) and pachymetry were followed over 3 years. Simultaneous Photorefractive keratectomy(PRK) and CXL was performed on 20 KC and 20 ectasia eyes. Intrastromal Corneal Ring Segments(ICRS) was performed on 51 KC and 6 ectasia eyes.
RESULTS: In KC, CDVA, spherical equivalence, sphere, cylinder and mean K improved at 3 years post-CXL(p-value<0.05), but, these values improved without reaching a statistical significance in ectasia. 12 of 54 eyes with ectasia(22.2%) and 4 of 111 eyes(3.6%) with KC had progression post CXL(p-value:0.0001). Ectasia patients diagnosed with progression were older at presentation (36.1 years) than non-progressive ectasia patients(31 years)(p-value:0.02), and also older than KC patients.
Sub-analysis excluding PRK and ICRS cases showed that there was an improvement in mean sphere (from -5.23±4.2D to-4.46±3.89D)(p-value:0.03) cylinder(from 2.54±1.68D to 1.97±1.51D)(p-value:0.03) mean keratometry(from 46.81±3.78D to 46.01±3.25D)(p-value:0.006) in KC patients 3 years post CXL(40patients). Compared to baseline, all the mean refractive and tomographic variables deteriorated at 3 years post CXL in ectasia(28 patients)(p-value>0.05). Also, 2 of 40 patients with KC(5%) vs. 7 of 28 patients with ectasia(25%) had progression 3 years post-CXL and the difference between both groups remained statistically significant(p-value:0.027).
CONCLUSION: Eyes with post-LASIK ectasia seems to be less responsive to CXL than KC.
Keywords
keratoconus, post- LASIK ectasia, collagen cross-linking
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This preprint is under consideration at International Ophthalmology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
elias jarade
beirut eye and ENT specialist hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 11 Mar, 2021
No community comments so far
Review #? received
Received 06 Mar, 2021
Reviewers invited
Invitations sent on 06 Mar, 2021
Editor assigned
On 14 Feb, 2021
First submitted
On 13 Feb, 2021
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
PURPOSE: To report the response of keratoconus(KC) and post-LASIK ectasia (referred as ‘’ectasia’’) to the corneal crosslinking(CXL) and to compare the rate of progression between KC and ectasia at 3 years.
METHODS: Retrospective cohort study of patients undergoing CXL for either KC or ectasia. 54 eyes(31 patients) with ectasia and 111 eyes(67 patients) with KC were included in the study. Corrected distance Visual acuities(CDVA), refraction, keratometry(K) and pachymetry were followed over 3 years. Simultaneous Photorefractive keratectomy(PRK) and CXL was performed on 20 KC and 20 ectasia eyes. Intrastromal Corneal Ring Segments(ICRS) was performed on 51 KC and 6 ectasia eyes.
RESULTS: In KC, CDVA, spherical equivalence, sphere, cylinder and mean K improved at 3 years post-CXL(p-value<0.05), but, these values improved without reaching a statistical significance in ectasia. 12 of 54 eyes with ectasia(22.2%) and 4 of 111 eyes(3.6%) with KC had progression post CXL(p-value:0.0001). Ectasia patients diagnosed with progression were older at presentation (36.1 years) than non-progressive ectasia patients(31 years)(p-value:0.02), and also older than KC patients.
Sub-analysis excluding PRK and ICRS cases showed that there was an improvement in mean sphere (from -5.23±4.2D to-4.46±3.89D)(p-value:0.03) cylinder(from 2.54±1.68D to 1.97±1.51D)(p-value:0.03) mean keratometry(from 46.81±3.78D to 46.01±3.25D)(p-value:0.006) in KC patients 3 years post CXL(40patients). Compared to baseline, all the mean refractive and tomographic variables deteriorated at 3 years post CXL in ectasia(28 patients)(p-value>0.05). Also, 2 of 40 patients with KC(5%) vs. 7 of 28 patients with ectasia(25%) had progression 3 years post-CXL and the difference between both groups remained statistically significant(p-value:0.027).
CONCLUSION: Eyes with post-LASIK ectasia seems to be less responsive to CXL than KC.
Figure 1
Figure 2
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