Association between sociodemographic factors, visual acuity and corneal topographic outcomes after collagen cross-linking in patients with keratoconus

PurposeTo determine the association between sociodemographic factors, visual acuity (VA) and corneal topography (Kmax and K2) following collagen cross-linking (CXL) in a cohort of ethnically-diverse keratoconus patients. MethodsThe records of 88 keratoconus patients who underwent CXL between January 2021 and December 2022 at Kings College Hospital were examined. Data on age, sex, ethnicity, deprivation deciles, significant postoperative complications, pre and postoperative best VA (BVA), Kmax and K2 were extracted. Univariate Kaplan-Meier and multivariate cox-regression survival analyses were used to determine outcomes of BVA stability, Kmax stability K2 stability and composite Kmax/K2 stability at 52 weeks after CXL. ResultsAt 52 weeks, there was an 81.1% (95% confidence interval (CI): 71.2%-87.6%) probability of BVA stability and 80.7% (67.4%-88.5%) probability of Kmax/K2 stability. Multivariate analyses showed significant associations (p<0.05) between Kmax/K2 stability and other ethnicity but not other sociodemographic factors. ConclusionCXL is associated with the stabilisation of vision and corneal topography in the majority of eyes. One significant association was found between other ethnicity and corneal topographical outcomes after CXL, however, no other significant associations were found between the majority of sociodemographic or economic factors with VA or corneal topographical outcomes after CXL. This suggests CXL results in good functional and anatomical outcomes independent of sociodemographic status.