Abstract
Purpose
To report cases of progressive keratoconus (KC) in patients aged ≥48 years and the
successful arrest of progression using corneal cross-linking (CXL) with riboflavin
and ultraviolet-A light.
Observations
Five eyes from four patients with progressive KC aged 48, 48, 51 and 54 years are
reported in this case series. All eyes were followed regularly after initial diagnosis.
Kmax was used as an indicator of progression and KC progressed at a rate of 1.4 diopters
in 6 months and 14.6 diopters in 14 months. All patients eventually received CXL,
and all were aged ≥50 years at the time of the procedure. One eye required two CXL
procedures to successfully stabilize the patient’s cornea.
Conclusion
Despite the probability of KC progression strongly declining after the age of 40 years,
it never becomes zero. It is therefore advisable to continue regular follow-up corneal
tomography examinations in patients with KC, even in their fifth and sixth decades
of life.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Contact Lens and Anterior EyeAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Keratoconus in children: a literature review.Cornea. 2020; 39: 1592-1598
- Resistance of corneal RFUVA–cross-linked collagens and small leucine-rich proteoglycans to degradation by matrix metalloproteinases.Invest Ophthalmol Vis Sci. 2013; 54: 1014-1025
- Genetics vs chronic corneal mechanical trauma in the etiology of keratoconus.Exp Eye Res. 2021; 202108328
- Incorrect sleeping position and eye rubbing in patients with unilateral or highly asymmetric keratoconus: a case-control study.Graefes Arch Clin Exp Ophthalmol. 2020; 258: 2431-2439
- Pregnancy-induced changes in corneal biomechanics and topography are thyroid hormone related.Am J Ophthalmol. 2017; 184: 129-136
- Late-onset progression of keratoconus after therapy with selective tissue estrogenic activity regulator.J Cataract Refract Surg. 2019; 45: 101-104
- Characterization of age-related variation in corneal biomechanical properties.J R Soc Interface. 2010; 7: 1475-1485
- Individualized corneal cross-linking with riboflavin and UV-A in ultrathin corneas: the Sub400 protocol.Am J Ophthalmol. 2021; 224: 133-142
- Keratoconus after 40 years of age: a longitudinal comparative population-based study.Int Ophthalmol. 2020; 40: 583-589
- Corneal cross-linking for progressive keratoconus in patients older than 40 years: long-term follow-up.J Refract Surg. 2021; 37: 338-342
Article info
Publication history
Published online: December 05, 2022
Accepted:
November 29,
2022
Received in revised form:
November 24,
2022
Received:
July 8,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
