Corneal irregularity improvement after topography customized photorefractive keratectomy followed by corneal cross-linking for progressive keratoconus

Session Details

Session Title: Cornea & Miscellaneous
Session Date/Time: Friday 15/02/2019 | 10:30-12:30
Paper Time: 10:54
Venue: Room MC3

First Author: V.Liarakos GREECE
Co Author(s): N. Kappos  K. Giannopoulou  G. Karastatiras           

Abstract Details

Purpose:

To evaluate possible improvement in topographical ectasia severity indices after Topography Customized Photorefractive Keratectomy followed by conventional Corneal Crosslinking (TC-PRK + CXL).

Setting:

AKTINA Center, Athens, Greece

Methods:

From a cohort of 40 successive CXL cases for progressive keratoconus, only cases that underwent the TC-PRK + CXL protocol were included in this retrospective nonrandomized case series. Eleven cases were finally included. A Dual Topography system (Scheimpflug combined with Placido, Tomey TMS-5) was used to evaluate ectasia severity before and 3 months after treatment. Corneal spectral domain Optical Coherence Tomography (Optovue) and Ray-tracing aberrometry (iTrace) were additionally performed. Excimer Laser 500MHz (Alcon Wavelight) with customized modified ablation profile was used, followed by conventional CXL (Dresden protocol). Statistical analysis was performed using SPSS version 22.

Results:

Ectasia Screening Index (ESI), Keratoconus Severity Index (KSI), Keratometric values (anterior and posterior), Cylinder values and Pachymetry values were correlated and evaluated. Keratometric Cylinder values were reduced significantly from 4.141.79D to 2.531.48D (p=0.04); average anterior ESI was reduced significantly from 58% to 33% (p=0.002) and average KSI was reduced from 57% to 43% (p=0.19). Pachymetry was reduced, but not significantly (from 48837μm to 42042μm, p=0.337). Posterior keratometric values and posterior ESI remained unaltered (p>0.05).

Conclusions:

The TC-PRK + CXL protocol may improve topographical corneal irregularity in keratoconic corneas, saving tissue at the same time; thus, protecting the cornea and possibly enhancing quality of vision at the same time.

Financial Disclosure:

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