First Author: I.Kremer ISRAEL
Co Author(s): I. Aizenman H. Lichter S. Shayer S. Levinger
Purpose:
Our aim was to study the results of simultaneous PRK and cross-linking therapy in keratoconus patients following Intacs implantation by Intralase
Setting:
Enaim Laser Center, Jerusalem, Israel.
Methods:
Our retrospective interventional case series study included 40 patients with moderate keratoconus (45 eyes), 27 males, 13 females, mean age 33.3 years, who previously underwent Intacs implantation by Intralase at least 6 months before cross-linking (CXL). Simultaneous wavefront-guided PRK followed by UVA CXL were performed at the same session. We examined the patients at 3, 6 and 12 months postoperatively, evaluating their refraction, UCVA, BCVA, keratometry, endothelial cell count, pachymetry, corneal resistance factor (CRF), and corneal hysteresis (CH). Statistical analysis was performed by the student t-test (2-tailed, paired).
Results:
The 6 months follow-up evaluation post PRK-CXL revealed that the mean UCVA improved significantly from 0.20 (±0.12) before treatment to 0.54 (±0.15) (p<0.01). Mean BCVA improved from 0.58 (±0.13) before treatment to 0.76 (±0.16) (p=0.01). Mean cylinder decreased from -3.60 (±1.70) to -1.29 (±1.13) diopters (p<0.001). Mean Apex keratometry decreased from 50.9 (±5.5) to 46.56 (±4.75) diopters (p<0.005). Mean K maximum decreased from 47.9 (±4.9) to 44.72 (±4.0) diopters (p=0.03) and mean K minimum decreased from 44.17 (±3.92) to 41.40 (±3.20) diopters (p=0.01) following treatment. All the other corneal parameters which were evaluated, including pachymetry, endothelial cell count, corneal hysteresis and resistance, did not change significantly following treatment. No significant difference was found between the 6 and 12 months results. No patient lost lines of BCVA. Mild haze remained in 11% of eyes, 12 months post treatment.
Conclusions:
Wavefront-guided PRK and CXL for keratoconus after Intacs implantation by Intralase is a safe and effective procedure. It was found to significantly improve UCVA, BCVA and central keratometry and consequently the visual function of patients with moderate keratoconus. FINANCIAL DISCLOSURE?: No
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