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Simultaneous topo‐guided photorefractive keratectomy (PRK) followed by collagen cross‐linking (CXL) for the treatment of keratoconus
Author(s) -
KONTADAKIS GA,
KYMIONIS G,
PORTALIOU D,
KOUNIS G,
KARAVITAKI A,
PALLIKARIS IG
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.3337.x
Subject(s) - keratoconus , corneal collagen cross linking , dioptre , medicine , photorefractive keratectomy , keratometer , ophthalmology , visual acuity , refractive error , corneal topography , ectasia , cornea , surgery
Purpose To present the results after simultaneous topoguided Photorefractive Keratectomy (PRK) followed by corneal collagen cross linking with Riboflavin/Ultraviolet – A irradiation (CXL) for the treatment of keratoconus. Methods In this prospective case series, 22 patients (27 eyes) with progressive keratoconus participated. All patients underwent customized topography guided photorefractive keratectomy (PRK) immediately followed by corneal collagen cross linking with the use of riboflavin and ultraviolet – A irradiation. Results Mean follow up was 10.72+5.98 months (range from 3 to 19 months). Mean preoperative spherical equivalent (SE) (diopters, D) and defocus were –3.03 ± 3.23D and 4.67±3.29D while at the last follow up examination were significantly reduced to ‐1.29 ± 2.05D and 3.04±2.53D, respectively. Preoperative mean (LogMAR) Uncorrected Visual Acuity (UCVA) and Best Spectacle Corrected Visual Acuity (BSCVA) were 0.99±0.81 and 0.21±0.19 while at the last follow up examination were improved to 0.16±0.15 and 0.11±0.15 respectively. Mean preoperative steepest meridian keratometry from 48.2±3.4D was reduced to 45.13±1.8D at the last follow up examination. Conclusion Simultaneous PRK followed by CXL seems to be a promising treatment capable of offering patients a functional vision and halting progression of the ectatic disorder. Longer follow up and larger case series are necessary in order to fully evaluate this new innovative combined procedure.