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24. Kongress der DGII 2010
Abstracts DGII 2010
IX.
Wissenschaftliche
Sitzung: Refraktive Chirurgie
V64
Hornhaut Crosslinking – Erfolgs- und
Komplikationsraten
Koller T
IROC AG, Zürich (Schweiz)
Purpose:
To enumerate the complication rate of corneal cross-linking
(CXL) for primary keratectasia and to find recommendations to
avoid complications. Setting: Institut für Refraktive und
Ophthalmo-Chirurgie (IROC), Zurich, Switzerland.
Methods: In a prospective
study, 117 eyes of 99 patients with verified progressive keratectasia
were enrolled and received standard CXL. Preoperatively, 6 months
and 12 months after CXL among others best spectacle-corrected
visual acuity (BSCVA), slit lamp inspection, applanation tonometry,
and Scheimpflug imaging (Pentacam) were used to follow the
post-operative development. Statistical analysis included ANOVA and
U-tests to detect risk-factors for complications.
Results: Approximately
90% completed the 12 month follow-up. The complication rate
(percentage of eyes loosing 2 or more Snellen lines) was 2.9% with a
95%-confidence interval of 0.6% to 8.5%. The failure rate of CXL
(percentage of eyes with continued progression) was in this study
7.6%. As significant risk factors for complications the parameters
"age> 35 years" and "preoperative BSCVA> 20/25" were identified,
preoperative high Kmax-reading was the only significant risk factor
for failure. In 7.6% of the eyes sterile infiltrates and in 2.8% central
stromal scars were found.
Conclusions:
Changing the inclusion
parameters may significantly reduce complications and failures of
CXL: preoperative Kmax-readings of less than 58D may reduce the
failure rate of CXL to less than 3% and restriction of the age of the
patient to less than 35 years may reduce the complication rate to 1%.
Erschienen in:
Klin Monatsbl Augenheilkd 2010; 227: Suppl. 1, S1–S24
Georg Thieme Verlag KG Stuttgart · New York · ISSN 1431-634X
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