Complications of accelerated corneal collagen cross-linking: review of 2025 eyes


ÇAKMAK S., Sucu M. E., Yildirim Y., Kepez Yildiz B., Kirgiz A., Bektasoglu D. L., ...Daha Fazla

INTERNATIONAL OPHTHALMOLOGY, cilt.40, sa.12, ss.3269-3277, 2020 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 40 Sayı: 12
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1007/s10792-020-01512-3
  • Dergi Adı: INTERNATIONAL OPHTHALMOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, BIOSIS, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.3269-3277
  • Anahtar Kelimeler: Corneal cross-linking, Complications, Accelerated CXL, Keratoconus, Down syndrome, Vernal keratoconjunctivitis, MICROBIAL KERATITIS, RIBOFLAVIN, KERATOCONUS, ASSOCIATION, EFFICACY, FAILURE
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Purpose To evaluate the early- and late-stage complications of accelerated cross-linking (A-CXL) in a large case series and investigate the relationship of A-CXL complications with ocular and systemic conditions accompanying keratoconus. Methods Retrospectively, records of 2025 eyes of 1184 patients diagnosed with keratoconus between March 2013 and 2020 who underwent A-CXL (18 mW/cm(2)for 5 min) treatment were reviewed. Comorbid ocular and systemic diseases other than keratoconus were recorded. In the postoperative follow-up, early and late complications and their association with accompanying diseases were examined. Results The mean age of patients was 26.16 +/- 6.05 (range 18-42), and the mean follow-up time was 3.40 +/- 1.63 years (range 1-8 years). Vernal keratoconjunctivitis (3.7%) was the most common disease accompanying keratoconus. Less frequently, systemic allergic diseases (2.9%) and Down syndrome (2.3%) were observed. The most common complication in the early postoperative period was haze formation (9.1%), while failure of the treatment (4.2%) occurred in the late period. Other common complications were loss of two or more Snellen lines (2.4%) and delayed epithelial healing (1.8%). There was a significant relationship between vernal keratoconjunctivitis and delayed epithelial healing (p = 0.011). Statistically significant relationships were found between Down syndrome and haze formation (p < 0.001) and sterile infiltrate formation (p = 0.041). Conclusion Although A-CXL complication rates are low, vernal keratoconjunctivitis following A-CXL might increase the risk of delayed epithelial healing, and similarly corneal haze and sterile infiltrates might be observed more frequently in patients with Down syndrome.