Binocular Visual Function Changes After Corneal Collagen Crosslinking In Keratoconus Patients

Published 2022 - 40th Congress of the ESCRS

Reference: PO257 | Type: Free paper | DOI: 10.82333/ht2f-rh02

Authors: Romina Fasciani* ¹ , Emanuele Crincoli ² , Chiara Fedeli ¹ , Maria Teresa Rebecchi ¹ , Marco Senneca ¹ , Luigi Mosca ¹ , Laura Guccione ¹ , Stanislao Rizzo ¹

¹Ophthalmology Department,Fondazione Policlinico Universitario A. Gemelli IRCCS,Roma,Italy, ²Ophthalmology Department,Università Cattolica del Sacro Cuore di Roma,Roma,Italy

Purpose

High order aberrations (HOAs) have been demonstrated to profoundly affect both visual acuity and stereoacuity in keratoconus patients. Corneal collagen crosslinking (CXL) has been proven to significantly lower HOAs in keratoconus. Yet, to the present date, no evaluation of the effect of the procedure on stereopsis has been performed. The purpose of the study is to assess differences in binocular visual performance in keratoconus patients before and after CXL.

Setting

Ophthalmology department of Policlinico Universitario Agostino Gemelli Hospital

Methods

The study prospectively analyzed keratoconus patients undergoing standard Dresden protocol epi-off CXL. Patients received slit-lamp examination, UDVA and CDVA assessment, corneal tomography, Lang stereotest, TNO stereoacuity assessment, distance and near Cover test and Irvine test before surgery and 6 months after CXL. Stereopsis tests were performed with spectacle correction.

Results

The analysis included 30 patients (mean age 24.63 ± 3.49 years). Lang test improved after treatment (p 0.027), with 6/30 patients (20%) showing a positive Lang test before CXL compared to 16/30 patients (53.3%) after treatment. Moreover, TNO stereoacuity increased after treatment (p 0.043) and 14/30 patients (46.7%) manifested an improvement of at least 250” at TNO test after CXL. In this subgroup of patients, total RMS values decreased after treatment (p <0.001), while patients that didn’t manifest clinically significant improvement in stereoacuity didn’t show a reduction in total RMS after CXL (p = 0.11). The results of Cover test and Irvine test didn’t vary after CXL.

Conclusions

Keratoconus patients showing reduction of HOAs after CXL also manifest significant improvement in stereoacuity after the treatment.