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Corneal collagen crosslinking for post-LASIK ectasia: two-year results

Session Details

Session Title: Cross-linking

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 16:04

Venue: Elicium 2 (First Floor)

First Author: : D.Wajnsztajn ISRAEL

Co Author(s): :    S. Frenkel   D. Landau   E. Strassman   J. Frucht-Pery      Correa

Abstract Details

Purpose:

To report the outcomes of corneal collagen crosslinking (CXL) treatment for progressive post-LASIK ectasia.

Setting:

Hadassah Medical Center - Hebrew University Hospital, Ophthalmology Department, Jerusalem, Israel

Methods:

We retrospectively reviewed all the files of patients who underwent CXL for post-LASIK ectasia between August 2007 and December 2012. Principal outcomes were best corrected visual acuity (BCVA), topography-derived maximum keratometry (Kmax), cylinder and mean 3mm central keratometry (mean K) during the first 2 years after CXL. CXL was done using Dresden protocol with regular or hypotonic riboflavin (UV-X ™ Specifications, IROC, Zurich, Switzerland). Statistical analysis included matched pair analysis with a Wilcoxon Test.

Results:

Twenty two eyes of 18 patients had CXL for progressing LASIK ectasia. Eleven patients were male and 7 were female. Twelve eyes were left and 10 were right eyes. Pre-treatment mean age was 31.3±6.8 years (ranging from 22 to 47 years) and mean pachymetry was 423.9±40.4?m (302 to 510?m). After 6 months post-CXL (n=19) Kmax, mean K, topographic cylinder and BCVA (Snellen decimal equivalent) improved from 53.2±6D to 51.6±5.7D (p=0.002), 47.1±5.2D to 46.2±5D (p=0.024), 2.7±1.9D to 2.5±1.6D (p=0.343) and 0.57±0.22 to 0.62±0.17 (p=0.137) respectively. One year post-CXL (n=18) Kmax, mean K, topographic cylinder and BCVA improved from 54.5±6.7D to 51.4±5D (p=0.0002), 47.2±5.1D to 46.3±4.1D (p=0.075), 3.5±3.6D to 2.4±1.5D (p=0.085) and 0.51±0.22 to 0.62±0.19 (p=0.012) respectively. Two years post-CXL (n=11) Kmax, mean K, topographic cylinder and BCVA improved from 51.9±6.8D to 48.9±5.7D (p=0.003), 45.9±5D to 44.2±4.4D (p=0.009), 3±2.1D to 2.4±1.4D (p=0.058) and 0.62±0.18 to 0.67±0.14 (p=0.141) respectively. Two eyes lost 1 line and 1 eye lost 2 lines of BCVA. One eye had sterile bandage contact lens-related infiltrate 4 days post-CXL that resolved with lens removal. One eye had mild deep lamellar keratopathy that was treated with systemic and topical steroids.

Conclusions:

CXL is a safe and efficacious procedure for treatment of progressing post-LASIK ectasia.

Financial Interest:

NONE