Posters

Combined topo-guided PRK and CXL with oxygen supplementation for keratoconus: two-year follow-up

Poster Details

First Author: C.Kranemann CANADA

Co Author(s):                        

Abstract Details

Purpose:

To determine the efficacy and safety of combined topo-guided PRK and topo-guided CXL over 2 year follow up

Setting:

Refractive clinic

Methods:

Prospective cohort of patients underwent topo-guided PRK followed by topo-guided accelerated CXL with central treatment zone of 4.5-5 mm (10 J) and outer zone of 6-7 mm (7.2 mJ) with Oxygen supplementation and 20 seconds of topical mitomycin application. All patients had pre- and postoperative topography/wavefront/cycloplegic refractions/endothelial cell count/tear osmolality and recording of any complications

Results:

23 eyes in 18 patients with Keratoconus or Pellucid Marginal Degeneration were enrolled. Mean best corrected visual acuity (BCVA) was 20/60 and range of K’s 46-54 preoperatively. Month 1 this improved to mean BCVA 20/50 and mean cylinder reduction 3.4 diopters. Month 6 the mean BCVA was 20/25 with K’s ranging from 42.7 to 49 and mean cylindrical reduction 5.5 diopters. Month 12 the mean BCVA was 20/20 with a range of cylinder from 42-48 diopters and mean cylindrical reduction of 5.5 diopters Month 24 the mean BCVA was stable at 20/20 (P<0.01) with a range of 41.8-47.9 cylinders (P<0.01) and mean reduction of 5.6 diopters (P<0.01). 3/30 eyes had ¼ haze for 1 month and 3/30 eyes had an IOP spike by month 1. 13/30 eyes had delayed epithelial healing resolved by month 1.

Conclusions:

The combination of topo-guided PRK and topo-guided CXL appears at least as effective as the conventional PRK/CXL approach. Over 2 years there was no further topographic flattening and maintained treatment effect. The potential for greater efficacy and less long term trend for progressive corneal flattening has to be verified in a larger sample size and longer term follow up.

Financial Disclosure:

None