Change in endothelial cell count after simultaneous PRK and cross-linking in patients with keratoconus

Session Details

Session Title: Photoablation, Cross-Linking and Intracorneal Ring Segment

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 08:12

Venue: Room 16

First Author: : P.Nano ARGENTINA

Co Author(s): :                        

Abstract Details

Purpose:

Evaluate the numerical change in endothelial cell count at 1, 3 and 6 months postop in 28 eyes with keratoconus treated with simultaneous PRK and corneal collagen cross-linking.

Setting:

Instituto de Ojos ,Dr Hugo Daniel Nano, Buenos Aires , Argentina

Methods:

28 eyes, mean age 29 with topographical diagnosis of keratoconus (SimK47.2D) included. Preoperative evaluation: UCVA, BSCVA; manifest,cicloplegic refraction, INPUT (70% sphere, 90% cylinder), keratometry (K1 K2), SimK and pachimetry with TOMEY T5 ®.Endothelial Cell Count with TOMEY EM-3000 ® Specular Microscope all by same technician. PRK without mytomicin using VISX STAR S4 IR (R) EXCIMER LASER (AMO Inc. Santa Ana CA) 9 mm diameter. Cross-Linking (same surgeon) using IROC UV-X™ 2000,0.1% riboflavin/20% dextran solution instilled every 3 minutes for 40 minutes,10 minutes corneal exposure, 365 +/- 10 nm WL, 9 mW/Cm2. Patients were assessed 1, 3 and 6 months postoperatively.

Results:

Preoperative stage: the MSph -1,41D; MCyl-4D and MSEq -3,41D. The UCVA was less than 20/80 in all cases. The BSCVA was between 20/80 and 20/40 in all cases. Preoperative Mean Cell Count was 2583 /mm2, mean pachimetry was 508 microns, and keratometry Mean K1: 48,5D, Mean K2: 43,8D. The Mean Input Sph -1,29D Cyl -3,96D, Mean Total Ablation Depth of 30,3 microns. Postoperative data 6 months follow-up: M Sph -0,50D; MCyl-0, 45D; and MSphEq -0,72D. UCVA between 20/80 and 20/25 in all cases. BSCVA between 20/50 and 20/25 in all cases. Mean K1: 43,58D and M K2: 41,68D, Mean Cell Count was 2100/ mm2. No loss of lines in BSCVA, the majority (66,7%) gaining between 2 and 5 lines (66,7%).

Conclusions:

Although more patients are needed, we can conclude that, there is a statistically significant loss in endothelial cell count (p=0,01 T-Student test) at 6 months follow-up. Longer follow up is needed to analyze if the cell count goes up again in the long term.

Financial Interest:

NONE