A question of corneal cross-linking (CXL) reducing keratoplasty numbers in keratoconics was addressed in this single centre observational study from the Oslo University Hospital – a sole provider of keratoplasties and CXL for a population of 2.8 million. Authors compared keratoplasty rates between two periods: period 1 – pre introduction of CXL (2005-2006) and period 2 – post introduction of CXL (2013-2014). The total number of keratoplasties in period 1 was 137 with 55 performed for keratoconus. In period 2 corresponding numbers were 231 and 26 respectively with the difference between the numbers of keratoconus keratoplasties in two periods being statistically significant. There were no significant differences in the age and gender distributions between both periods, but interestingly in period 2 only 3 patients were younger than 25 versus 13 in period 1. There were significantly more stage 4 keratoconus patients undergoing keratoplasty in period 2 compared to period 1. These results point to a significant reduction of keratoplasties for keratoconus between two periods, which is most likely secondary to the introduction of CXL into clinical practice. However further large longitudinal studies are needed to make definite conclusions.

Does collagen cross-linking reduce the need for keratoplasties in patients with keratoconus?
Sandvik GF, Thorsrud A, Råen M, et al.
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Magdalena Popiela

Royal Gwent Hospital, Cardiff, UK.

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