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Combined Topo-Guided PRK&CXL with Oxygen supplementation 3 year follow up

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First Author: C.Kranemann CANADA

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Abstract Details

Purpose:

To determine the relative efficacy and safety of topo-guided PRK combined with topo-guided CXL and oxygen supplementation over a 3 year follow up.

Setting:

refractive clinic

Methods:

A prospective and consecutive pilot study with combined topo-guided PRK immediately followed by topo-guided CXL with oxygen supplementation and a central 5 mm zone centred on the centre of the cone and a 1.5 mm transition zone followed by Mitomycin for 20 seconds. Preop and postop Keratometry/topography/corneal endothelial cell counts/refraction/tear osmolality/lens opacity scores were obtained and statistical analysis performed. Follow up was in 6 monthly intervals for at least 36 months.

Results:

30 eyes of 21 patients completed the study. Preop mean CDVA was 20/60 with a range of K's 46 to 54 diopters. At 36 months postop the mean CDVA was 20/22 (P<.01), UDVA 20/32 (P<.01), range of K's 41.5-47.3 diopters (P<.01) with a cylinder reduction mean of 5.3 diopters. 3/30 eyes had 1/4 temporary haze, 3/30 eyes had an IOP spike and 13/30 eyes experienced delayed epithelial healing. There was no statistically significant change in tear osmolality, lens opacity score or endothelial cell count at 36 months.

Conclusions:

Topo-guided PRK with topo-guided CXL and oxygen supplementation and a smaller treatment zone appears relatively effective and safe in the setting of this pilot study. Larger and possibly randomized studies comparing it to more traditional approaches might be warranted.

Financial Disclosure:

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