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COVID-19 impacts keratoconus patients waiting for corneal crosslinking


Researchers at the Royal College of Ophthalmologists offer guidance on the impact of treatment delays in crosslinking (CXL) amid COVID-19 on patients with keratoconus.

A group of researchers is offering its guidance on the impact of treatment delays in crosslinking (CXL) amid COVID-19 on patients with keratoconus.

According to investigators from the Royal College of Ophthalmologists, treatment delays for patients with keratoconus have led to progression and visual worsening.1

The investigators examined the impacts of delays of CXL in patients with keratoconus progression.

The study reviewed 46 patients with keratoconus progression, for whom CXL was delayed due to the COVID-19 pandemic.

Details, including demographics and clinical data, were drawn SOMETHING MISSING? from on the day of scheduling, and subsequently reviewed on the day of the procedure. The data included keratometry of the posterior and anterior corneal surfaces, maximal keratometry, thinnest corneal thickness, ABCD progression, and progression based on standard criteria recommendations.

Investigators analyzed a total of 46 eyes with an average time between being scheduled for CXL and undergoing the procedure at 182 ± 65 days. The average delay as a result of the pandemic was 3 months.

During this time, the patients had significant worsening of all keratometric indices and lost almost 1 line of visual acuity (0.19 ± 0.19 to 0.26 ± 0.18 logarithm of the minimum angle of resolution, p=0.03).

According to the study, 32 eyes (70%) had progression in accordance with the ABCD progression criteria, while 18 eyes (39%) had either an increase in keratometry of more than 1.5 diopters or corneal thinning of at least 20 μm.

“We recommend that corneal collagen CXL needs to be considered as a high priority intervention,” the investigators said.


1 Haider Shah, Luca Pagano, et al, Impact of COVID-19 on keratoconus patients waiting for corneal cross linking, Eur J Ophthalmol, accessed March 15, 11206721211001315. doi: 10.1177/11206721211001315.

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