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Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus.

Lang SJ, Messmer EM, Geerling G, Mackert MJ, Brunner T, Dollak S, Kutchoukov B, Böhringer D, Reinhard T, Maier P - BMC Ophthalmol (2015)

Bottom Line: This difference was statistically significant (p = 0.02).Therefore, further investigations are necessary to decide which patients require treatment and which do not.NCT00626717, Date of registration: February 20, 2008.

View Article: PubMed Central - PubMed

Affiliation: Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. stefan.lang@uniklinik-freiburg.de.

ABSTRACT

Background: Corneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy.

Methods: The efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model.

Results: A total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/-standard deviation) by 0.35 +/- 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/- 0.61 dioptres/year. This difference was statistically significant (p = 0.02).

Conclusions: Our data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not.

Trial registration: NCT00626717, Date of registration: February 20, 2008.

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Related in: MedlinePlus

Consort flow-chart. Three patients had an incomplete follow-up of one year. The data were included in the analysis. One patient belonged to the treatment arm, the other two to the placebo group
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Fig1: Consort flow-chart. Three patients had an incomplete follow-up of one year. The data were included in the analysis. One patient belonged to the treatment arm, the other two to the placebo group

Mentions: The consort chart is depicted in Fig. 1. One patient had to be excluded prior to randomization since the inclusion criteria were not fulfilled, leaving 29 patients available for analysis. Of these, 15 patients had documented progression of keratoconus; the remaining 14 patients had reported visual deterioration or worsening of spectacle refraction. The mean age at inclusion was 28 years (median range: 17 to 53). In total, 15 patients were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 (quartiles 802 to 1131) days. Baseline and follow-up characteristics of the treatment and control group are summarized in Table 1. Three patients had an incomplete follow-up and did not participate in further examinations after one year; one of these three belonged to the treatment arm, the other two to the placebo group.Fig. 1


Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus.

Lang SJ, Messmer EM, Geerling G, Mackert MJ, Brunner T, Dollak S, Kutchoukov B, Böhringer D, Reinhard T, Maier P - BMC Ophthalmol (2015)

Consort flow-chart. Three patients had an incomplete follow-up of one year. The data were included in the analysis. One patient belonged to the treatment arm, the other two to the placebo group
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4508968&req=5

Fig1: Consort flow-chart. Three patients had an incomplete follow-up of one year. The data were included in the analysis. One patient belonged to the treatment arm, the other two to the placebo group
Mentions: The consort chart is depicted in Fig. 1. One patient had to be excluded prior to randomization since the inclusion criteria were not fulfilled, leaving 29 patients available for analysis. Of these, 15 patients had documented progression of keratoconus; the remaining 14 patients had reported visual deterioration or worsening of spectacle refraction. The mean age at inclusion was 28 years (median range: 17 to 53). In total, 15 patients were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 (quartiles 802 to 1131) days. Baseline and follow-up characteristics of the treatment and control group are summarized in Table 1. Three patients had an incomplete follow-up and did not participate in further examinations after one year; one of these three belonged to the treatment arm, the other two to the placebo group.Fig. 1

Bottom Line: This difference was statistically significant (p = 0.02).Therefore, further investigations are necessary to decide which patients require treatment and which do not.NCT00626717, Date of registration: February 20, 2008.

View Article: PubMed Central - PubMed

Affiliation: Eye Center, Albert-Ludwigs-University of Freiburg, Killianstr. 5, 79106, Freiburg, Germany. stefan.lang@uniklinik-freiburg.de.

ABSTRACT

Background: Corneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy.

Methods: The efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model.

Results: A total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/-standard deviation) by 0.35 +/- 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/- 0.61 dioptres/year. This difference was statistically significant (p = 0.02).

Conclusions: Our data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not.

Trial registration: NCT00626717, Date of registration: February 20, 2008.

Show MeSH
Related in: MedlinePlus