Étude rétrospective concernant le crosslinking cornéen accéléré avec haute irradiance dans le cadre du traitement du kératocône

Abstract

To evaluate the safety and efficacy of accelerated corneal collagen crosslinking on stabilization of progressive keratoconus. This was a retrospective study from March2013 to March2015. Patients with progressive keratoconus who underwent accelerated corneal collagen crosslinking were included. Visual acuity with and without correction, biomicroscopy, corneal elevation topography (maximum and mean keratometry values, minimum pachymetry, densitometry) and side effects were recorded at baseline and at 1, 3 and 6months (M). One hundred and ten eyes of 84patients were included. At month6, we found an improvement in corrected distance visual acuity (CDVA) with a small improvment of 0.069±0.15logMAR (P=0.009). Uncorrected distance visual acuity remained unchanged. The mean minimum corneal pachymetry was 455μm at baseline and 449μm at m6 (P<0.001). There was no statistically significant difference between pre- and postoperative mean keratometry values (M1, M3, M6). We likewise found no difference in maximum keratometry between pre- and postoperative values at M1, M3 and M6 (P>0.1). With regard to safety, we report 1case of postoperative infectious keratitis and 1case of anterior non-granulomatous uveitis after treatment in patients without any known past ocular history. The results we found in this study after accelerated corneal crosslinking are similar to those with conventional crosslinking protocols published in the literature. High irradiance accelerated corneal collagen crosslinking appears to be a reliable and effective therapeutic alternative for progressive keratoconus, allowing for a more brief procedure.