Posters

Late results of customized treatment of keratoconus and corneal ectasias with customized mini excimer laser treatment (CMELT), and customized corneal collagen cross-linking (CCXL): is it possible to get topographic recovery with very limited surgery?

Poster Details

First Author: U. Erdem TURKEY

Co Author(s):    S. Altun   A. Tas   A. Ilhan   S. Dagli           

Abstract Details

Purpose:

To explain our customized surgical treatment of keratoconus (KC) or ectasia with customized corneal collagen cross-linking (CCXL) and customized mini excimer laozer treatment (CMELT), and. to review the outcomes of the patients in the first 5 years.

Setting:

Since visual results of CXL treatment were not satisfied the patients, topography guided treatments developed for better VA. But it was not flexible and mostly limited to a certain amount of ablation. We have developed a surgical method with 7 stage customization to get more efficient results for keratoconus.

Methods:

Customized keratoconus and corneal ectasia treatment based on a series of customizable parameters including corneal topography, corneal wavefront map, location of keratoconus apex, corneal thickness, shape and width of ectasia, visual acuity, age,… to get more efficient results with very limited corneal ablation. Surgical outcomes of the patients (189 eyes; 182 KC and 7 ectasia) follow up results in the first 5 years reviewed with retrospective data analysis for wound healing, maximum keratometry (KMax, DK), corneal topography indices, wavefront aberrations uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) from our clinical trials.

Results:

The mean follow up time was 27.4±12.3 months, flattening in KMax was 4.4 ± 2.7D with 30.2± 6.3µ planned ablation. All eyes gained one or more, 173 eyes 2 or more, 112 eyes gained 3 or more Snellen line BSCVA. Improvements are even seen at 1 months and remain stable after 12 months. The steeper KMax more likely to gain more KMax flattening, and the eyes with preoperative of 20/40 or worse BSCVA were more likely to gain more Snellen lines after treatment if the corneal thickness was over 400µ. 67 eyes revealed anterior topographic recovery. 1 corneal ectasia case developed recurrent epithelial erosion several times. No serious complications encountered, No patient needed additional cxl treatment.

Conclusions:

Customized treatment of keratoconus with corneal collagen cross-linking and customized mini excimer lazer treatment (CCXL, and CMELT) safe and effective treatment for keratoconus and corneal ectasia, with serious improvements in optical measures and visual acuity. This surgical system uses multiple parameters for corneal remodelling. The best of our knowledge this method is gives one of the best treatment options ever with minimal tissue damage even with anterior topographic recovery

Financial Disclosure:

NONE