[Corneal scar development after cross-linking in keratoconus].
BACKGROUND
Corneal scar development after riboflavin-UVA-induced corneal collagen cross-linking (CXL) was retrospectively evaluated.


METHODS
A total of 163 CXL-treated eyes in 127 patients with stage 1-3 keratoconus according to Krumeich's classification were included in this retrospective analysis. The follow-up period was 1 year. At the first and at all follow-up examinations uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), biomicroscopic findings, corneal topography and corneal thickness were recorded.


RESULTS
At 1 year following CXL, 149 eyes (91.4%) of 114 patients had a clear cornea without corneal scar (control group), while 14 eyes (8.6%) of 13 patients developed clinically significant corneal scar (scar group). Preoperatively, the mean K value of the apex was 62.1 ± 13.8 D in the control group and 71.1 ± 13.2 D in the scar group (P=.02). The mean value of corneal thickness before the procedure was 478.1 ± 52.4 μm in the control group and 420.0 ± 33.9 μm in the scar group (P=.001). The UCVA and BCVA, which were preoperatively similar between groups (P=.59, P=.75 respectively), were postoperatively improved in the control group (P=.023, P=.001 respectively), but reduced in the scar group (P=.012, P=.004 respectively).


CONCLUSIONS
K-values and corneal thickness could be considered as predictive factors for the possible development of corneal scarring after riboflavin-UVA-induced CXL. Advanced keratoconus appears to be associated with a higher risk of corneal scar development due to lower corneal thickness, greater curvature and intrinsic tissue characteristics.
Raiskup
F
F
Universitätsklinikum Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden. frederik.raiskup@uniklinikum-dresden.de
Kissner
A
A
Hoyer
A
A
Spörl
E
E
Pillunat
L E
LE
D000328:Adult; D002921:Cicatrix / Q000175:diagnosis* / Q000209:etiology*; D003318:Corneal Opacity / Q000175:diagnosis* / Q000209:etiology*; D003432:Cross-Linking Reagents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000628:therapy*; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects*; D012256:Riboflavin / Q000009:adverse effects; D016896:Treatment Outcome; D014466:Ultraviolet Rays / Q000009:adverse effects
D003432:Cross-Linking Reagents; D012256:Riboflavin