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P-16 How to assess the effectiveness of corneal cross-linking for keratoconus: need of a shared protocol
  1. Mariacarmela Ventura1,
  2. Matteo Airaldi2,3,
  3. Luca Pagano3,
  4. Kunal Gadhvi3,
  5. Stephen Kaye3,
  6. Vito Romano2,3
  1. 1Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy
  2. 2Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
  3. 3St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
  4. *


Objective Comparing definitions of progression in keratoconus (KC) patients after corneal cross-linking (CXL).

Methods Retrospective case series of KC eyes underwent CXL. Keratoconus progression after CXL treatment was defined based on either the widely accepted standard criteria (i.e., maximum keratometry (Kmax), increase >1 Diopter (D) or thinnest corneal thickness (ThCT) reduction >20 mm) or the ABCD progression criteria.

Results Thirty-seven KC eyes underwent CXL. Kmax showed a significant reduction from baseline values after CXL (p<0.01), while no difference in ThCT (p=0.12) and in CDVA (p=0.1) was found. Applying standard criteria for progression 18.9% (7/37) of eyes were classified as progressed and 43.2% (16/37) according to the ABCD method.

Conclusions Different definition of progression leads to increased misclassification, there is a need of a shared protocol to assess the effectiveness of CXL.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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