Biomechanical consequences of keratoconus treatments

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Abstract

Purpose

to evaluate, biomecanical consequences of Crosslinking (CXL) in keratocônus, with intracorneal ring (ICR) or not, with a new instrument : Corvis © (Oculus).

Methods

Our prospective study included ten patients with evolutive keratoconus (i.e. keratometric modification more than 0.5 D and/or refraction modification in 6 months), with pachymetry superior to 400 microns. For patients had both CXL and ICR (operated 3 months after CXL), six CXL only. The procedure was flash CXL (4 minutes of riboflavine, 15 minutes of UltraViolets). Patients were seen at 1, 3 and 6 months, with visual acuity, topography, corvis (deformation amplitude, aplanation length, corneal velocity), vidéotopography.

Results

The evaluation of corneal biomechanical properties of the cornea with corvis shows, after CXL, an increase of the aplanation lentgh of the second palanation pic : 0,8 pre-CXL, 1,02 post-CXL. Now, A2’s length is usually decreased in keratoconus compared to normal cornea. Therefore, the A2 lenght change after CXL could be a parameter for the follow-up after CXL to show it’s efficacy.

Conclusion

Corvis can be another tool in keratoconus’ follow-up, based on the impacts of treatments (ICR and CXL) on biomechanical properties of the cornea.

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