The Short term outcomes of corneal collagen crosslinking (CXL) and its determinants in treatment of corneal pathologies at Dhahran eye hospital, Saudi Arabia.

To evaluate the short term outcomes of corneal collagen crosslinking (CXL) in treatment of corneal pathologies at a tertiary eye hospital in Eastern Saudi Arabia and identify the predictors of visual outcomes.

Abstract

PURPOSE: To evaluate the short term outcomes of corneal collagen crosslinking (CXL) in treatment of corneal pathologies at a tertiary eye hospital in Eastern Saudi Arabia and identify the predictors of visual outcomes.

METHODS: In this one armed cohort study, cases of corneal pathologies that underwent collagen cross linkage treatment between 2014 -2016 at our institute were included. Data included demography and diagnosis. Corneal parameters, Intra ocular pressure (IOP), Un-Corrected Visual Acuity (UCVA) and the Best Corrected Visual Acuity (BCVA) at presentation, central corneal thickness (CCT) and at 6 months after CXL were compared. 

RESULTS: We studied 96 eyes of 96 patients with corneal pathologies (92 keratoconus). UCVA (Wilcoxon P = 0.05), IOP (W P <0.001), CCT (W P <0.001), astigmatism (P = 0.02), corneal curvature (K₁) (W P <0.001) and K₂ (P = 0.04) significantly improved 6 months after CXL. Corneal haze of grade 1 was noted in 39 [(40.6% (95% CI 30.8 ; 5.4)] eyes six months after CXL. The haze was not associated/correlated to Gender (P = 0.7), laterality (p = 0.5), diagnosis (p = 0.6), pre-IOP (P = 0.3), pre- CCT (p = 0.9) and age (p = 0.4). The presence of corneal haze was not significantly associated to the grade of keratoconus (P = 0.8).

CONCLUSIONS: CXL seems to be safe and efficient. Short term gain of CXL in treatment of corneal ectasia is significant. However corneal haze was noted in four of ten cases and we could not identify significant predictors of corneal haze.

KEY WORDS: Keratoconus; collagen cross linkage, corneal ectasia, corneal topography.