Journal of Clinical and Experimental Ophthalmology
Open Access
ISSN: 2155-9570
ISSN: 2155-9570
Junaid Faisal Wazir
University of Lahore, Pakistan
Posters & Accepted Abstracts: Clin Exp Ophthalmol
Statement of the Problem: Keratoconus is a disorder of the cornea which results in progressive thinning of the cornea that induces irregular astigmatism, resulting in impairment of vision. keratoconus is derived from Greek words kerato (cornea) and konos (cone). It usually affects both the eyes and may result in corneal perforation of corneal scaring. Keratocnus is usually diagnosed in second and third decade of life and affects quality of life of young adults. Keratoconus affects about 1 in 2000 people. Despite considerable research, the cause of keratoconus remains unclear. Several sources suggest that keratoconus likely arises from a number of different factors: genetic, environmental or cellular, any of which may form the trigger for the onset of the disease. However, the exact mechanism by which it manifests in terms of progression, genetic heterogeneity and phenotypic diversity is not known, thereby resulting in a series of diverse diagnostic and treatment methods. The purpose of this study is to report on 1-year postoperative visual outcome with the corneal cross linkage for keratoconus patients. Methodology: This was a prospective interventional study. Fifteen patients (30 eyes) age 15â??40 years with systemic and other ocular diseases except keratoconas were included in this study and treated with corneal collagen crosslinking (CXL) in 1 year follow up in Hospital. These cases were selected using a non- random consecutive sampling method. Before starting the study, informed written consent was taken from every participant before study. Study approval was taken from institution ethical review committee of Pakistan Instittue of Community Ophthalmology (PICO) Peshawar. After 6 months post CXL, the refraction was declared as stable if there was a change in refraction of six subjective refractions within +0.75 D of spherical equivalent. Those patients were included whose best corrected visual acuity was 6/12, K max <53, intraocular pressure (IOP) <21mm Hg, clear cornea, normal ACD of at least 3.5 mm to the endothelium width of angle greater than 30 degree. Contact lens use was discontinued for at least 2 weeks for rigid lenses and 1 week for soft lenses before any intervention. Those patients who were mentally disabled, pregnant, lactating mothers and those who didnâ??t signed consent form were excluded from the study. Findings: At 1-year follow-up, 45% had 20/20 vision or better and 100% had 20/40 or better uncorrected visual acuity (UCVA). Vector analysis of refractive astigmatism shows that the initial astigmatism (SIA) (3.20+ 1.46 D) was not significantly different from the target induced astigmatism (TIA) (3.14 ¬+1.42 D) (p=0.620). At 1 years postoperatively, none of the eyes showed a decrease in UCVA, in contrast to 24 eyes in which UCVA was increased by 1 lines, with contrast sensitivity and improvement in total aberrations and MTF value at 5 per degree (*p=0.004) after CXL surgery. The cumulative 1- year corneal endothelial cell loss was 5%. No patients reported dissatisfaction. At the end of follow- up, the vault was 658 + 54.33m (range, 500â??711) and the intraocular pressure was 11.7 + 2.08 mm Hg. Occurrences of glare and night-driving troubles diminished after CXL surgery.