Keratoconus Progression Classification One Year After Performed Crosslinking Method Based on ABCD Keratoconus Grading System

Abstract

Introduction: Keratoconus is described as a degenerative bilateral, progressive, noninflammatory corneal disorder characterized by ectasia, thinning, and increased curvature. Keratoconus progression classification 1 year after performed crosslinking method in this study is based on the ABCD keratoconus grading system. Aim: To evaluate the possible keratoconus progression one year after performed a crosslinking (CXL) method based on the ABCD keratoconus grading system. Methods: Seventeen keratoconus patients (22 eyes) were included in this prospective study. CXL procedure was performed using the standard Dresden protocol at Eye Clinic Svjetlost Sarajevo with the inclusion period from January 2017 to January 2018. Twelve patients had monocular, and 5 patients had binocular treatments with follow up of 12 months. Preoperative and postoperative stages were compared using the ABCD keratoconus grading system measured on rotating Scheimpflug corneal tomography-based machine-Pentacam (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). Results: Out of 22 eyes, one eye had keratoconus stage I-II, 6 eyes had stage II, 4 eyes had stage III, and 9 eyes had stage III-IV. There was no statistically significant gradient change of keratoconus in comparison to one month after the surgery, p>0.05. There was no progression of the gradient when comparing to the preoperative stage. Conclusions: Corneal cross-linking could effectively stabilize the progression of keratoconus, as assessed by key corneal topographic parameters. Analyzing the trend of stage change in 12 months follow up after the crosslinking procedure of keratoconus patients there was no progression of a gradient in comparison to the preoperative stage. According to our results, we can conclude that CXL is a safe and effective procedure in treating keratoconus.

Cost analysis of eye bank versus surgeon prepared endothelial grafts

“…In 2019, 30,650 EK procedures were performed in the United States of America alone, accounting for more than 60 % of the total grafts performed [ 4 ]. Similar trends are observed in Europe, with the most recent published annual European eye bank audit reporting 10,137 EK procedures compared to 8,169 PK emphasizing the shift towards EK [ 5 , 6 ].…”

Evaluation of corneal biomechanical behavior in vivo for healthy and keratoconic eyes using the stress–strain index

“…3 Although the shape changes are subsequent effects of the underlying biomechanical instability, KC has been characterized and staged and its natural course tracked regarding those secondary effects rather than regarding the primary biomechanical cause. 16 There have been 2 major challenges in attempting to detect and define KC from a biomechanical perspective: first, to identify the appropriate unit of measure that will reflect a true biomechanical characteristic of the cornea and will not be significantly confounded by corneal geometry or IOP and, second, to be able to make reliable, consistent, and noninvasive measurements in vivo.…”

“…The Belin ABCD platform, which combines both, would manifest only after these secondary changes have occurred. 16 The BAD-D and TBI, both sensitive parameters to detect subclinical KC, would still need subtle shape changes to register a progression of the disease. 14,20 The SSI, on the contrary, has the potential to reflect early changes in the tangent modulus and thus be able to detect progression at its very biomechanical root.…”

Safety and Efficacy of Scleral Lenses for Keratoconus

“… 13 Several grading schemes exist to classify keratoconus severity and to track its progression, 13 , 33 , 34 but there is no consensus on a standard. 35 The Amsler-Krumeich system, 34 the Belin-Belin Ambrósio Enhanced Display, 36 and the ABCD grading system 37 were considered and rejected because some fail to account for posterior corneal changes, require analysis that was not performed on all subjects in our study, or do not incorporate clinical findings. The Keratoconus Severity Score ranking system, which grades the disease severity from 0 to 5 based on biomicroscopy signs, topography pattern, and common topographic indices, was chosen for its lack of ties to any particular topographic instrument, high sensitivity and specificity, and record of good reproducibility.…”