Simultaneous topography-guided TransPRK and corneal collagen cross-linking for management of post LASIK ectasia

Session Details

Session Title: Advanced Surface Photoablation I

Session Date/Time: Sunday 08/10/2017 | 08:00-09:30

Paper Time: 09:09

Venue: Meeting Center Room I

First Author: : M.Baragheeth KUWAIT

Co Author(s): :                        

Abstract Details

Purpose:

To evaluate the results of combined trans-epithelial photorefractive keratectomy (Trans-PRK) and corneal collagen cross linking (CXL) in eyes that developed ectasia after myopic laser in situ keratomileusis (LASIK).

Setting:

New Mowasat Hospital, Kuwait

Methods:

Noncomparative, prospective, interventional case series involved twenty eyes with keratectasia of 12 patients previously treated by LASIK for myopia and myopic astigmatism. Eyes were treated by Trans-PRK and CXL at least six months after LASIK. The PRK ablation parameters (diameter, attempted correction) were selected to avoid theoretical flap perforation. The deepest ablation was 60 micron. Schwind Amaris 750s laser was used for trans-PRK and Avedro Ultraviolet Light cross-linking system used for cross-linking. Mean outcome measures were: refraction, uncorrected (UCVA) and best-corrected visual acuity (BCVA), slit-lamp evidence of corneal opacity or other visible complications, and corneal topography.

Results:

Prior to Trans-PRK enhancement the mean manifest spherical equivalent was: –1.75 D ± 1.96 D (range from - 0.75 to -2.75). At 1 year follow up 75% of the eyes were within ± 1.00 D SE. The mean UCVA improved from 20/80 preoperatively to 20/30 postoperatively. The average gain in lines for the UCVA was 2.75. Nine eyes (45%) developed mild to moderate haze which has completely resolved by the third postoperative month.

Conclusions:

Simultaneous approach of topography guided trans-PRK and CXL resulted in significant clinical improvement and apparent stability of the ectasia during the post-operative follow-up. That approach offers a solution to post LASIK ectasia. Longer follow-up and larger patient sample is necessary in order to validate the safety and the stability of this combined procedure.

Financial Disclosure:

NONE