title: Effects and adverse events after CXL for keratoconus are independent of age: a 1-year follow-up study.
abstract: OBJECTIVE
  To compare the effect, failure rate and the risks of corneal cross-linking (CXL) in keratoconus patients aged ≥35 years to patients <35 years.
  
  
  METHODS
  In 141 eyes of 116 keratoconus patients we compared the changes in best phoropter-corrected visual acuity (BCVA) and maximum keratometry values (Kmax) before and 12 months after CLX in patients aged ≥35 years (n=34, 38 eyes) to the cohort of patients below 35 years of age.
  
  
  RESULTS
  Overall, CXL significantly improved BCVA from 0.487 logMAR (95% confidence interval (CI) 0.426-0.548) by -0.197 logMAR (95% CI -0.243 to -0.150; P<0.001) and reduced Kmax from 48.96 diopter (Dpt) by -1.33 Dpt (95% CI -1.85 to -0.81: P<0.001). Age ≥35 years had no effect on the changes of BCVA (-0.02 (95% CI -0.13 to 0.09); P=0.757) or Kmax (0.58 (95%CI -0.51 to 1.68); P=0.294) as compared with younger patients. In 54 patients (55 eyes, 38.5%) aged <35 years and in 18 patients (18 eyes, 47.4%) aged ≥35 years, BCVA increased by ≥2 Snellen lines. Failure (increase in Kmax ≥1 Dpt) was observed in 17 eyes (16.5%) of patients aged <35 years and in 3 eyes (7.9%) of patients aged ≥35 years during the 12-month follow-up period. Adverse outcomes (loss of ≥2 Snellen lines) occurred in 4 (3.9%) eyes of patients aged <35 years and 1 (2.6%) eye of a patient aged ≥35 years.
  
  
  CONCLUSIONS
  Effects and adverse events of CXL treatment do not seem to differ between subjects younger or older than 35 years.
authors.affiliation: Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland.
authors.forename: P B
authors.initials: PB
authors.lastname: Baenninger
authors.affiliation: 1] Medignition Inc. Healthcare Innovations, Zug, Switzerland [2] Horten Center, University of Zurich, Zurich, Switzerland.
authors.forename: L M
authors.initials: LM
authors.lastname: Bachmann
authors.affiliation: Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Wienecke
authors.affiliation: Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Kaufmann
authors.affiliation: Department of Ophthalmology, Cantonal Hospital of Lucerne, Zug, Switzerland.
authors.forename: M A
authors.initials: MA
authors.lastname: Thiel
mesh_terms: D000328:Adult; D000367:Age Factors; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012256:Riboflavin / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D012256:Riboflavin