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Topography-guided photorefractive keratectomy and cross-linking for ectasia after laser assisted in situ keratomileusis

Session Details

Session Title: Keratoconus and ectasia

Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00

Paper Time: 17:27

Venue: Elicium 2 (First Floor)

First Author: : S.Holland CANADA

Co Author(s): :    D. Lin   G. Moloney   J. Tan        

Abstract Details

Purpose:

To evaluate early results of topography-guided photorefractive keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) for ectasia after laser assisted in situ keratomileusis (LASIK).

Setting:

Laser Eye Centre

Methods:

37 eyes of 26 patients with post-LASIK ectasia were treated using Allegretto Wavelight laser (AW) TG-PRK with simultaneous CXL. Trans epithelial PRK was performed with custom Topographical Neutralization Technique (TNT). Pre and post-operative assessment of symptoms, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction (MR) predictability, and safety were analyzed.

Results:

18 of 37 eyes treated by the AW laser had sufficient data at 12 months for analysis. 11 of 18 (61%) showed UCVA ?20/40. 8 eyes (44%) gained two or more lines of BSCVA while 1 (6%) lost two or more lines. Mean reduction in astigmatism (RIA) was 2.52D. All but 3 patients symptomatically improved.

Conclusions:

Early results of custom TG-PRK with CXL shows promise as an effective and safe treatment for post-LASIK ectasia All but 3 patients had improved symptoms. More than half of the eyes treated recovered UCVA of 20/40 and also improved BSCVA. This study demonstrates an alternative treatment for highly symptomatic patients with post- LASIK ectasia with contact lens intolerance, potentially avoiding a corneal transplant.

Financial Interest:

NONE