Athens protocol after femtosecond-assisted intracorneal ring implantation

Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 14:40

Venue: Room A3, Podium 3

First Author: : J.Mello Amaral BRAZIL

Co Author(s): :    R. Ambrosio Jr   B. Lopes                 

Abstract Details

Purpose:

To report safety and efficacy on visual outcomes and manifest refraction after Athens Protocol (same day surface ablation + corneal crosslinking) in patients with ectasia who previously underwent femtosecond-assisted intrastromal corneal ring implantation (fs-ICRS).

Setting:

Visare Personal Laser and Refracta Rio

Methods:

We evaluated forty-two eyes of 40 patients operated by the Athens Protocol in an interval of 15 days to 46 months after fs-ICRS with minimal follow-up of 1 month. Pre- and post-operative uncorrected distance visual acuity (UDVA), distance-corrected visual acuity (DCVA), and manifest refraction were retrospectively compared by non-parametric Friedman test. All eyes had ICRS position evaluated by FD-OCT prior to the Athens Protocol procedure in order to assure at least 200microns of residual stroma over the ICRS after ablation.

Results:

Complete epithelial healing was observed in all eyes within the first 7 days after Athens Protocol. No eye lost DCVA after Athens Protocol following fs-ICRS. All variables had a statistically significant improvement between the pre-operative and the last observation time-points (p<0.01). DCVA improved from logMAR0.44±0.2 to logMAR0.21±0.20 (p<0.00001), manifest astigmatism improved from -5.01±2.36 to -2.42 ±1.87(p<0.00001) and spherical equivalent improved from -6.07±4.92 to -3.33±3.87 (p=0.0007).

Conclusions:

There is a synergistic additive effect of the Athens Protocol following fs-ICRS which was considered a safe and efficient procedure to improve visual acuity for patients with ectasia. Studies considering a longer follow-up are needed as guidelines for preoperative planning, in order to assure stromal thickness over the ICRS prior to Athens Protocol.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company