Posters

Modified Athens protocol in the management and visual rehabilitation of keratoconus: topography-guided partial PRK normalization first, followed by 50um PTK to account for epithelium, followed by variable fluence, topography-customized pattern CXL

Poster Details

First Author: A. Kanellopoulos GREECE

Co Author(s):                        

Abstract Details

Purpose:

To investigate clinical safety and efficacy of topography-guided partial excimer-laser ablation employed to normalize the anterior cornea surface combined with variable-fluence, topography-customized pattern CXL.

Setting:

the Laservsiion Clinical and Resecrh Institute, Athens, Greece

Methods:

45 consecutive cases treated with the EX500 Wavelight excimer, part of the Refractive Suite and the KXL II CXL device with the following Steps: 1. Partial topography-guided excimer-laser PRK ablation 2. PTK Excimer-laser ablation to account for epithelial removal, employed AFTER the step #1 (50-μm, 8.00-mm zone). 3. variable higher-fluence and variable shape Customized UV-A delivered in custom-designed CXL pattern Long-term stability assessed with refraction, keratometry, Placido topography, Anterior-Segment-OCT, and Scheimpflug-imaging

Results:

All cases had one-year refractive, keratometric, and anterior-surface irregularity indices improvement superior to our previously published standard Athens Protocol results. Average Keratometry improvement: from 51.5 Diopters to 45.4 D, UDVA: from 20/70, to 20/40, CDVA from 20/40 to 20/25, Index of Height Decentration (IHD): from 0,155 to 0,042. Keratoconus stage (1-4): from 3 to 1-2 in average.

Conclusions:

Topography-guided partial PRK with excimer laser combined with customized variable fluence and pattern UV-A delivery CXL (vCXL) leads to improved visual rehabilitation outcomes with similar stability established, and potentially a more effective normalization with less cornea tissue removal due to the added refractive effect of vCXL.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented