Customised phototherapeutic keratectomy epithelial removal for corneal collagen cross-linking: visual and tomographic results

Session Details

Session Title: Cross-Linking

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 15:44

Venue: Room A3, Podium 3

First Author: : L.Izquierdo Jr PERU

Co Author(s): :    M. Rincon   D. Altamirano   M. Cerrate   M. Henriquez           

Abstract Details

Purpose:

To evaluate the efficacy and safety of customized Phototherapeutic keratectomy (PTK) epithelial removal for corneal collagen crosslinking (CXL) in progressive keratoconus.

Setting:

Oftalmosalud Instituto de Ojos, Lima, Peru.

Methods:

Prospective, pre and post case series study included 15 eyes of 15 patients with progressive keratoconus. Customized PTK epithelial removal was performed before CXL using the Excimer laser Amaris 1050, focused on the maximum posterior float elevation; de-epithelization area was delimited by the shorter and longest diameter of the posterior float. Standard CXL (30 minutes of impregnation with Riboflavin 0.1% solution + 20% Dextran 500 and 30 minutes of irradiation 3mW/cm2) was performed in all eyes. Pre and postoperative at 3 and 6 months visual acuity, refraction and Scheimpflug imaging analysis was recorded and evaluated, also days for complete epithelization.

Results:

Mean uncorrected visual acuity (VA) improvement was 0.30 LogMAR (p=0.09) and mean best-corrected VA improvement was 0.03 LogMAR (p=0.58). Mean steeper keratometry improvement was 0.37 Diopters (D), p=0.09. Mean pachymetric change at the thinnest point was -27.22 (p=0.009), mean decrease in the sphere was -0.64 (p=0.14), mean decrease in the cylinder was -0.28D (p=0.27). Mean change in the posterior elevation at the thinnest point was -2.55 um (p=0.06). No complications were reported in any eye. Mean epithelization days was 1.2 days (SD: 2.2).

Conclusions:

Customized Phototherapeutic keratectomy (PTK) epithelial removal for corneal collagen crosslinking (CXL) in progressive keratoconus is safe and effective to halt the progression of the keratoconus allowing less de-epithelization area in a standard CXL procedure.

Financial Disclosure:

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