Advertisement

Progressive keratoconus in patients older than 48 years

Published:December 05, 2022DOI:https://doi.org/10.1016/j.clae.2022.101792

      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 access
      One-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 Eye
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Buzzonetti L.
        • Bohringer D.
        • Liskova P.
        • Lang S.
        • Valente P.
        Keratoconus in children: a literature review.
        Cornea. 2020; 39: 1592-1598
        • Zhang Y.
        • Mao X.
        • Schwend T.
        • Littlechild S.
        • Conrad G.W.
        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
        • Rabinowitz Y.S.
        • Galvis V.
        • Tello A.
        • Rueda D.
        • García J.D.
        Genetics vs chronic corneal mechanical trauma in the etiology of keratoconus.
        Exp Eye Res. 2021; 202108328
        • Mazharian A.
        • Panthier C.
        • Courtin R.
        • Jung C.
        • Rampat R.
        • Saad A.
        • et al.
        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
        • Tabibian D.
        • de Tejada B.M.
        • Gatzioufas Z.
        • Kling S.
        • Meiss V.S.
        • Boldi M.-O.
        • et al.
        Pregnancy-induced changes in corneal biomechanics and topography are thyroid hormone related.
        Am J Ophthalmol. 2017; 184: 129-136
        • Torres-Netto E.A.
        • Randleman J.B.
        • Hafezi N.L.
        • Hafezi F.
        Late-onset progression of keratoconus after therapy with selective tissue estrogenic activity regulator.
        J Cataract Refract Surg. 2019; 45: 101-104
        • Elsheikh A.
        • Geraghty B.
        • Rama P.
        • Campanelli M.
        • Meek K.M.
        Characterization of age-related variation in corneal biomechanical properties.
        J R Soc Interface. 2010; 7: 1475-1485
        • Hafezi F.
        • Kling S.
        • Gilardoni F.
        • Hafezi N.
        • Hillen M.
        • Abrishamchi R.
        • et al.
        Individualized corneal cross-linking with riboflavin and UV-A in ultrathin corneas: the Sub400 protocol.
        Am J Ophthalmol. 2021; 224: 133-142
        • Hashemi H.
        • Asgari S.
        • Mehravaran S.
        • Emamian M.H.
        • Fotouhi A.
        Keratoconus after 40 years of age: a longitudinal comparative population-based study.
        Int Ophthalmol. 2020; 40: 583-589
        • Vinciguerra R.
        • Fossati G.
        • Sorrentino T.
        • Legrottaglie E.F.
        • Piscopo R.
        • Rosetta P.
        • et al.
        Corneal cross-linking for progressive keratoconus in patients older than 40 years: long-term follow-up.
        J Refract Surg. 2021; 37: 338-342