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

• Published in: Revista Brasileira de Oftalmologia Vol. 83
• Main Authors: Borges, Vinícius Gomes Ribeiro, Stival, Larissa Rossana Souza, Nassaralla, Anna Paula Amaral, Nassaralla, Belquiz Rodrigues do Amaral
• Format: Journal Article
• Language: English; Portuguese
• Published: Sociedade Brasileira de Oftalmologia 01.08.2024
• Subjects: Adolescent; Child; Corneal cross-linking; Keratoconus; Retreatment
• ISSN: 0034-7280; 1982-8551
• DOI: 10.37039/1982.8551.20240042

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.