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Case Reports
. 2023 Apr;46(2):101792.
doi: 10.1016/j.clae.2022.101792. Epub 2022 Dec 5.

Progressive keratoconus in patients older than 48 years

Léonard Kollros  1 , Emilio A Torres-Netto  2 , Carmen Rodriguez-Villalobos  3 , Nikki L Hafezi  4 , Mark Hillen  5 , Nan-Ji Lu  6 , Farhad Hafezi  7
Affiliations
Case Reports

Progressive keratoconus in patients older than 48 years

Léonard Kollros et al. Cont Lens Anterior Eye. 2023 Apr.

Abstract

Purpose: To report cases of progressive keratoconus (KC) in patients aged ≥48 years and the successful arrest of progression using corneal cross-linking (CXL) with riboflavin and ultraviolet-A light.

Observations: Five eyes from four patients with progressive KC aged 48, 48, 51 and 54 years are reported in this case series. All eyes were followed regularly after initial diagnosis. Kmax was used as an indicator of progression and KC progressed at a rate of 1.4 diopters in 6 months and 14.6 diopters in 14 months. All patients eventually received CXL, and all were aged ≥50 years at the time of the procedure. One eye required two CXL procedures to successfully stabilize the patient's cornea.

Conclusion: Despite the probability of KC progression strongly declining after the age of 40 years, it never becomes zero. It is therefore advisable to continue regular follow-up corneal tomography examinations in patients with KC, even in their fifth and sixth decades of life.

Keywords: Age; CXL; Cornea; Corneal biometry; Corneal cross-linking; Corneal tomography; Corneal topography; Eye rubbing; Keratoconus; Progression.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: F. Hafezi is a coinventor of the ultraviolet-A irradiation light source, PCT/CH application 2012/000090. The remaining authors have no conflicts of interest to disclose. No other authors have financial disclosures, proprietary or commercial interest in any materials discussed in this article..

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