Efficacy And Safety Of Standard Corneal Cross-Linking Procedures Performed With Short Vs Long Riboflavin Induction: A Save Sight Keratoconus Registry Study

Published 2022 - 40th Congress of the ESCRS

Reference: FPM10.06 | Type: Free paper | DOI: 10.82333/w36s-sj46

Authors: Blanca Benito-Pascual* ¹ , Himal Kandel ² , Marco Abbondanza ³ , Richard Mills ⁴ , Laurence Sullivan ⁵ , Stephanie Watson ²

¹cornea,Hospital Severo Ochoa Madrid,Madrid,Spain, ²Sydney Eye Hospital,Sydney,Australia, ³Abbondanza Eye Centres,Rome and Milan,Italy, ⁴Flinders Medical Centre ,Adelaide,Australia, ⁵Bayside Eye Specialists,Victoria,Australia

Purpose

To compare the effectiveness and safety of short vs long riboflavin induction times in crosslinking (CXL) for keratoconus.

Setting

Save Sight Keratoconus Registry

Methods

A retrospective comparative study was conducted with data from Save Sight Keratoconus Registry. Inclusion criteria were: epithelium off technique, standard UVA CXL protocol (3 mW/cm² for 30 minutes), riboflavin induction for 15 min (short) or 30 minutes (long) and one year of follow-up data after CXL. Outcome measures included changes in visual acuity (VA), keratometry in the steepest meridian (K2), maximum keratometry (Kmax), thinnest pachymetry (TCT) and adverse events. Analysis was conducted using mixed-effects regression models adjusted for age, sex, visual acuity, keratometry, pachymetry, practice, and eye laterality.

Results

280 eyes (237 patients; mean, 27.3 ± 10.5 years old; 30% female) were included. Riboflavin induction time was short in 102 eyes (82 patients) and long in 178 eyes (155 patients). The baseline characteristics (gender, mean age, habitual visual acuity, keratometry, and pachymetry) were similar between the groups. At the one-year follow-up visit, no statistically significant differences were observed in flattening in K2 and improvement in visual acuity. Greater Kmax flattening (-1.5 Diopters (D) vs -0.5D, p=0.031) and a greater proportion of > 2% increase in TCT (23.5 vs 11.3 p=0.034) and haze (29 vs 15, p=0.005) were observed with short riboflavin induction.

Conclusions

Short and long riboflavin induction times achieved similar degrees of flattening in K2 and improvement in vision. Greater improvements in Kmax and TCT were seen with short riboflavin times and this group had higher rates of haze.