Case Reports

Management of progressive keratoconus with ray-tracing optimized, partial in refraction-amount, PRK combined with CXL: The ray-tracing Athens Protocol.

Case Report Details

First Author: I.Kontari GREECE

Co Author(s):    A. Kanellopoulos                    

Abstract Details

Purpose:

To report a novel ray-tracing customization of excimer ablation for normalization of irregular corneas, combined with higher fluence CXL in the effective management and visual rehabilitation of progressive keratoconus.

Setting:

LaserVision Clinical and Research Eye Institute

Report of Case:

A 28 year old male with bilateral progressive keratoconus was treated with Athens Protocol CXL: combined with a photorefractive ablation customized by a novel artificial intelligence platform calculating low and high order aberrations based on wavefront, Scheimpflug tomography and interferometry axial length data from a single diagnostic device. Visual Acuity, refractive error, cornea clarity, keratometry, topography, endothelial cell density were evaluated over six months. Keratoconus stabilized in both eyes. The keratoconus stage by Amsler-Krumeich criteria improved from 2 to 1. Uncorrected Distance Visual Acuity (UDVA) changed from preoperative 20/80 to 20/20 in the OD and 20/25 in the OS at six months. A maximum astigmatic change of 2.8 D and 4,2 D appear in the comparison maps respectively in the OD and the OS, and significant cornea surface normalization (IHD improvement from 0.117 to 0.092 in the OD and 0.066 to 0.024 in the OS

Conclusion/Take Home Message:

We introduce herein CXL combined with novel excimer laser customization employing several independent up-till-now diagnostics. It bears the potential advantage of addressing more accurately normalization of the defected human eye optics associated with corneal ectasia, compared to using anterior corneal surface data alone.

Financial Disclosure:

None