Determination of the frequency of crosslinking failure in the treatment of primary progressive keratoconus, preliminary assessment of its predictors

    Abstract

    Original article

    Determination of the frequency of crosslinking failure in the treatment of primary progressive keratoconus, preliminary assessment of its predictors

    Yu.V. Kutuzova, E.L. Sorokin

    S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk Branch, Khabarovsk, Russian Federtaion
Far-Eastern State Medical University, Khabarovsk, Russian Federation

    Purpose. To evaluate the clinical efficacy of corneal collagen crosslinking (CCL) in the treatment of various stages of primary progressive keratoconus KC to determine the incidence of insufficient therapeutic effect.

    Material and methods. 60 eyes with primary progressive KC stages 1–3 (60 patients) aged 13–46 years (mean age 27 years). There were 38 were men and 22 were women among them. Morphometric parameters of the cornea were assessed using a scanning keratopograph Pentacam (Oculus, Germany). All patients were divided into 3 groups according to the KC stage (stage 1 — 16 eyes, stage 2 — 31 eyes, stage 3 — 13 eyes). In all cases, the crosslinking procedure was performed according to the standard Dresden protocol.

    Results.After one year of observation, the average maximum keratometry (Kmax) value in the total number of patients statistically significantly decreased — from 53.4 (49.7; 59.3) to 52.2 (48.3; 58.6) D. In 9 patients (15%), the Kmax value, on the contrary, increased from 61.8 D to 66.7 D. Of these, 3 patients had stage 2 KC, and 6 patients had stage 3 KC. The age of the 9 patients with ineffective CXL ranged from 16 to 41 years (on average, 27 years), and they were all male.

    Conclusions. 1. The standard CXL technique demonstrated high clinical efficacy in the treatment of primary KC — 85%. 2. CXL was effective in all patients with stage 1 primary KC. Further progression of primary KC was observed in 15% of patients after 1 year of observation, which was expressed in an increase in the Kmax index and a decrease in best-corrected visual acuity. All of them initially had stages 2 and 3 KC.

    Keywords: keratoconus, crosslinking, corneal ectasia

    For citation: Kutuzova Yu.V., Sorokin E.L. Determination of the frequency of crosslinking failure in the treatment of primary progressive keratoconus, preliminary assessment of its predictors. Rossiyskaya detskaya oftalmologiya. 2025;4(54): 22–26. https://doi.org/10.25276/2307-6658-2025-4-22-26

    Corresponding author: Yulia V. Kutuzova, naukakhvmntk@mail.ru