First Author: E.McElnea IRELAND
Co Author(s): M. O'Keefe
Purpose:
To determine whether riboflavin and ultraviolet A (UV-A) corneal cross-linking can be used to prevent the progression of keratectasia in patients post laser in situ keratomileusis (LASIK) while maintaining visual acquity (VA) and illustrate some of the difficulties in managing this unfortunate condition.
Setting:
The Laser Suite, The Mater Private Hospital, Dublin, Ireland.
Methods:
Corneal collagen cross-linking based on a standard treatment protocol of pre-treatment with riboflavin, epithelial removal, and concurrent UV-A light exposure with additional riboflavin administration was performed on 7 eyes in 6 patients who had had LASIK for myopic astigmatism and who had subsequently developed keratectasia. Outcomes examined included best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent (MRSE), and steepest keratometry value before and after this procedure.
Results:
Corneal crosslinking induced by riboflavin and UV-A arrested keratectasia over a mean postoperative follow-up of 16 months as demonstrated by stable post operative corneal topography and a reduction in maximum keratometric readings (mean = 4.7 Dioptres). Treatment was however associated with a mean loss of 1.4 Snellen lines of BSCVA.
Conclusions:
Riboflavin and UV-A cross-linking provides a reliable means by which to arrest the progression of LASIK induced keratectasia but may, in some cases, be associated with a reduction in BSCVA. Identification of patients at risk for this condition, their diagnosis and management remains challenging. FINANCIAL DISCLOSURE?: No
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