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Peripherical corneal cross-linking to halt keratoconus progression after corneal graft

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First Author: J.Grandin ARGENTINA

Co Author(s):    C. Gordillo   A. Lotfi                 

Abstract Details

Purpose:

To describe the surgical technique and outcomes of the combined technique, peripheral corneal cross linking (CXL) to halt the progression of keratoconus (KC) in residual corneal ring in patients with previous corneal graft in combination with intrastromal ring segment implantation (ICR) to reduce high astigmatism after the graft.

Setting:

Cornea Department, Zaldivar Institute, Mendoza, Argentina.

Methods:

The inclusion criteria were patients with KC with previous corneal graft, high regular astigmatism (over 5 D), corneal instability attributable to presence of thinning due to KC progresion in peripherical corneal ring. 30 eyes of patients with previous corneal graft were treated with simultaneous peripherical corneal flash CXL (18 mW/cm2 for 5 minutes) in combination with intrastromal ring segment implantation. The outcomes measures were UDVA, CDVA, refractive astigmatism, keratometrics values and corneal stability are described in patients with 3 years of follow up.

Results:

The mean age of the patients was 35.86 years, improvements were observed in the values of UDVA, CDVA and reduction of the values of the cylinders and keratometry with statistically significant results. UDVA changed from 0.78 + / to -0.73 (SD) to 0.5 +/- 0.5, CDVA improved from 0.44 +/- 0.36 to 0.2 +/- 0.33. The mean cylinder changed from 5.71 +/- 1.86 tp 3.59 +/- 2.41. K max decreased from 49.62 to 45.51 with corneal stability. No intra or postoperative complications were described.

Conclusions:

Progresion of KC due to peripheral corneal inestability in association with high astigmatism can be treated using the combined technique of flash corneal cross-linking to halt the progression and ICR high regular astigmatism can be reduce ussing combined ICR implantation as a safe and reproducible technique presenting surface regularization and corneal stability.

Financial Disclosure:

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