What are the costs, capacity, and clinical implications of ‘waiting for documented progression’ in young West of Scotland patients prior to collagen cross linking?

Simpson, Alasdair; Brogan, Kerr; Ramaesh, Kanna; Lockington, David

doi:10.1038/s41433-021-01444-x

Cited by 3 publications

(3 citation statements)

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“…Furthermore, recent reports have suggested CXL in certain high‐risk patients groups, such as paediatric patients, without traditional documented progression. Furthermore, as this was a study on real‐world practice, we did not strictly define adverse events in our study such as clinically significant haze and persistent epithelial defect, leading to further heterogeneity in our results 36,37 …”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, as this was a study on real-world practice, we did not strictly define adverse events in our study such as clinically significant haze and persistent epithelial defect, leading to further heterogeneity in our results. 36,37 Only epithelium-off CXL procedures were included in this study to align with the most common clinical practice and protocol characteristics varied. These included intra-operative factors such as riboflavin type used, soaking duration, 38 UV-light power and duration, 27 as well as post-operative factors such as the use of bandage contact lenses post-op and topical steroid or antibiotic choice and course duration.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, as this was a study on real‐world practice, we did not strictly define adverse events in our study such as clinically significant haze and persistent epithelial defect, leading to further heterogeneity in our results. 36 , 37 …”

Section: Discussionmentioning

confidence: 99%

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Five‐year corneal cross‐linking outcomes: A Save Sight Keratoconus Registry Study

Ferdi

Kandel

Nguyen

et al. 2022

Clinical Exper Ophthalmology

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Background: We aimed to determine the long-term outcomes of epitheliumoff cross-linking (CXL) in keratoconus patients.Methods: An observational registry study from 41 centres across 5 countries was carried out. Primary outcomes included the mean change in visual acuity (VA), Kmax, K2, and thinnest corneal thickness (TCT) at 1-5 years. Secondary outcomes included the percentage of eyes with worsening, stable and improving outcomes.Results: There were 976 eyes of 794 patients with 1-year of complete follow-up, 501 eyes with 2-years, 355 with 3-years, 235 with 4-years and 162 with 5-years. There was a significant improvement in mean VA from baseline by 3.7 logMAR letters (p < 0.001) in year 1, and 6.9 (p < 0.001) in year 5. Mean Kmax decreased by 1.2 dioptres (D; p < 0.01) in year 1. During subsequent years the Kmax flattening appeared sustained but this was not statistically significant. K2 flattened significantly from baseline in year 1 and then remained stable. At 1 year, 4.1% patients were poor responders to CXL in terms of VA, losing ≥15 letters. The proportion of the poor responders remained unchanged: 4.9% at 5-years. The proportion of poor responders in terms of Kmax remained similar: 5.9% steepening by ≥2D at 1-year and 7.5% at 5-years. The proportion of K2 poor responders remained stable with 4.7% steepening by ≥2D at 1-year and 5.8% at 5-years.Conclusions: Cross-linking is effective at stabilising keratoconus up to 5 years in most patients. However, a small proportion of eyes failed to stabilise and had reduced vision.

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Section: Discussionmentioning

confidence: 99%