This retrospective cohort study examined 405 patients (405 index eyes and 218 untreated fellow eyes) who underwent cross-linking over a 12-year follow-up duration at Duke Eye Center. Preoperative and postoperative intraocular pressure (IOP) measurements were collected at ~1 month, 3 months, and ≥4.5 months postoperatively. Generalised estimating equation models included time point, tonometry method (iCare, Tonopen, Goldmann applanation tonometry), corticosteroid use, age, sex and race. In treated eyes, IOP significantly increased at 1 month (2.2mmHg increase, p=0.001) and remained elevated at 3 months (1.1mmHg increase, p<0.001), returning to baseline by ≥4.5 months (p=0.168). No significant IOP change was observed in untreated fellow eyes at any postoperative time point. Tonopen measurements were consistently higher than iCare (all p<0.001). iCare measurements showed significant elevation at 1 month postoperatively (p=0.005), and Tonopen measurements at 1 month and 3 months (both p<0.001). No elevation was observed beyond 3 months with any tonometry method. To conclude, corneal collagen cross-linking was associated with transient IOP elevations postoperatively that normalised by ≥4.5 months, and IOP measurements vary by tonometry method. Clinicians should be aware of IOP fluctuations in patients undergoing crosslinking and adapt management strategies for patients with glaucoma or ocular hypertension.
Incidence of high IOP following corneal collagen cross-linking
Reviewed by Su Young
Intraocular pressure changes following corneal cross-linking in patients with keratoconus.
CONTRIBUTOR
Su Young
Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, UK.
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