Topography-guided photorefractive keratectomy with collagen cross-linking for keratoconus

Session Details

Session Title: Cornea: Surgical II

Session Date/Time: Sunday 08/10/2017 | 14:30-16:00

Paper Time: 15:36

Venue: Room 3.6

First Author: : S.Holland CANADA

Co Author(s): :    D. Lin   J. Hogden   N. Davey              

Abstract Details

Purpose:

To evaluate one year results of topography-guided Photorefractive Keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) for keratoconus

Setting:

Laser Refractive Clinic

Methods:

A retrospective consecutive series of keratoconic eyes were studied to evaluate the outcomes of Topographic Guided Photorefractive Keratectomy (TG-PRK) treatment with the Schwind Amaris 1050 Excimer laser and simultaneous corneal collagen cross-linking (CXL). Image capture with Sirius and CXL with a modified Dresden protocol. Pre-operative and post-operative uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), manifest refraction (MR) and topographic cylinder were analyzed. Cases with sufficient data at 12 months follow-up were included.

Results:

266 eyes with keratoconus underwent treatment and 136 had sufficient data at 12 months for analysis 72 of 136 (53%) showed UCDVA ≥20/40 post-operatively. 62 (46%) had improved CDVA and 30 eyes (22%) gained two or more lines (p=0.0003). No patient showed progression. Mean astigmatism was reduced from 3.07±1.90D to 1.62±1.65D (p<0.0001). Mean spherical equivalent was improved from -3.14±3.89D to -0.90±2.71D (p<0.0001).

Conclusions:

Early results of TG-PRK (Schwind Amaris) treatment with CXL for keratoconus show efficacy and safety, with more than half of patients achieving 20/40 UCDVA or better. Over half also had improved CDVA and one-quarter had CDVA improvement of two or more lines. This larger study demonstrates an alternative treatment for contact lens intolerant keratoconic patients with further follow-up needed term to demonstrate longer term stability.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented