Use of donors predisposed by corneal collagen cross-linking in penetrating keratoplasty for treating the patients with keratoconus

4 years ago

Use of donors predisposed by corneal collagen cross-linking in penetrating keratoplasty for treating the patients with keratoconus

To investigate whether use of donors predisposed by corneal collagen cross-linking (CXL) reduced myopic refractive errors for keratoconic eyes after penetrating keratoplasty (PK).

Design

Randomized controlled trial.

Methods

One hundred sixteen eyes of 116 patients with keratoconus from Zhongshan Ophthalmic Center were enrolled. Using stratified block randomization, eligible eyes were assigned to CXL graft group (Group1) or conventional graft group (Group2). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), and topographic data were compared 12,24,and 36 months after surgery.

Results

Group1 had better UDVA and CDVA than Group2 after 1-year follow up. Also, Group1 had less degree of SE and lower manifest cylinder than Group2. At 3-years follow up, mean CDVA was 0.17±0.10 logarithm of the minimum angle of resolution (logMAR) in Group1 versus 0.23±0.12logMAR in Group2 (p=0.004). Mean SE was -3.50±2.93D in Group1; while -4.02±2.57D in Group2 (p=0.034). Mean manifest cylinder was -5.22±2.64D and -6.35±2.80D in Group1 and Group2, respectively (p=0.013). At 3-years follow up, simulated keratometry in the steepest meridian (Kmax) was 46.85 ± 2.85 D versus 49.37 ± 2.92 D (p=0.036); corneal power was 44.41± 2.89 D versus 46.35 ± 2.87 D (p=0.001); keratometric astigmatism was 4.53± 1.06 D versus 5.98 ± 1.28 D (p<0.001) in Group1 and Group2, respectively.

Conclusions

Use of donors predisposed by CXL could reduce topographic readings after PK for the treatment of keratoconus, consequently reduce myopic refractive errors and improved visual acuity.

Publisher URL: www.sciencedirect.com/science

DOI: S0002939417304269