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Keratoconus treatment modalities: cross-linking plus topoguided laser protocol vs intrastromal corneal ring segments

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First Author: R.Pinheiro PORTUGAL

Co Author(s):    T. Monteiro   J. Gil   E. Costa   A. Rosa   M. Quadrado   J. Murta     

Abstract Details

Purpose:

To compare two treatment modalities for keratoconus: cross-linking and intrastromal ring segments at 12 months of follow-up.

Setting:

Multicenter, retrospective clinical study

Methods:

This is a multicentre, retrospective clinical study comparing two groups, one with 58 eyes submitted to partial topograpgy-guided PRK combined with high-fluence CXL (group 1) and the other with 75 keratoconic eyes that underwent implantation of intrastromal corneal ring segments (group 2). Group 2 selected paracentral keratoconus with coincident refractive, keratometric, and comatic axes only.

Results:

Mean age in group 1 was 32.9 ± 9 years-old and in group 2 was 33.87 ± 11.78 years old and male prevalence was 59% and 61%, respectively. Comparing preoperative parameters of both groups, there were no statistically significant differences in mean BCVA, sphere and cylinder. Group 1 had higher K1 and K2 vs group 2, but the mean KMax was similar among both. Outcomes were analysed by comparison of morphologic characteristics preoperatively and at 12 months after the procedure, either cross-linking or intrastromal corneal ring implantation. Both groups had a significant improvement in BCVA at 12 months postoperative as well as a reduction in the keratometry indices. There were no statistically significant differences between the group 1 and group 2 improvements in BCVA, mean reduction in K2 and KMax. The power of the sphere increased in the first group and the cylinder decreased. On the other hand, the sphere decreased and the cylinder increased in the second group. Group 2 had more postoperative complications. On a case-by-case analysis, preoperative parameters that could have contributed for the unsuccessful outcomes were noted in each group.

Conclusions:

Both methods seem equally effective in improving BCVA and flattening the cornea. Intracorneal ring segments were more effective in reducing sphere and cross-linking plus laser were more effective in reducing cylinder. There was a higher postoperative complication rate in the second group.

Financial Disclosure:

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