Rajasekar K1, Sujatha R2
Keratoconus affects a significant number of the general population with conical weakened protruded area from the cornea due to weakening of the corneal stroma by a genetically premeditated preponderance. We see keratoconus as a standalone disease or accompanying other syndrome manifestations in patients. Mainly, the inferotemporal cornea is affected and the conical protrusion causes profound high irregular myopic astigmatism as a refractive error, which is very difficult to correct in progressed advanced stages. Especially in economically productive age group patients, the poor vision becomes very difficult to live with. Corneal collagen crosslinking procedure is a novel tool in the armamentarium of treatment procedures against this malady.
MATERIALS AND METHODS
This analytical study was conducted at cornea services, Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai, for a period of 14 months. Forty five eyes of forty patients with early progressive keratoconus who presented to cornea services were subjected to riboflavin UVA collagen crosslinking procedures using a standard protocol after getting an informed consent. Further response to treatment were assessed in the follow up period.
Out of 40 patients in our series, 23 were males and 17 were females. The maximum patients in our series were in the age group between 10 to 25 yrs. Epi-off procedure was done in 31 eyes and epi-on procedure was done in 14 eyes. The patients with pachymetry 400-450 microns underwent epi-on procedure and more than 450 microns underwent epi-off C3R procedure. The K values in our series were between 49D to maximum 63D. The topographic flattening was seen in 52% in epi-on and epi-off procedures. Vision improvement in our series was 57% following epi-on and 65% following epi-off procedures.
C3R is a very promising therapeutic modality that may halt the progression of ectatic process. It is a less invasive mode of treatment, which gives better outcome. This treatment is now being offered to patients with documented progression of keratoconus, but we are sure that with more experience, refinement in the process will allow it to be done in all stages of the disease and be a very important treatment process in this progressive disease.