Combined topography-guided photorefractive keratectomy and topography-guided corneal cross-linking with oxygen supplementation in keratoconus: pilot study

Session Details

Session Title: Cross-Linking Protocols

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

Paper Time: 14:06

Venue: Room A3, Podium 3

First Author: : C.Kranemann CANADA

Co Author(s): :                        

Abstract Details

Purpose:

To determine the effectiveness and safety of topography guided crosslinking (Topo-CXL) with topography guided photorefractive keratectomy (Topo-PRK) with oxygen supplementation.

Setting:

Clearview Institute Refractive Clinic

Methods:

30 eyes with keratoconus were prospectively enrolled to undergo Topo-PRK (60 micron removal) with Mitomycin and consecutive Topo-CXL with Oxygen supplementation. A standard CXL safety protocol was utilized. All eyes underwent pre and post operative cycloplegic and manifest refractions/corneal and total eye wavefronts/topographies and Tear Osmolalities at mongth 1,3, 6 and 12. Adverse effects including delayed epithelial healing, haze, infection and intraocular pressure (IOP) spikes were recorded.

Results:

30 eyes of 18 patients were enrolled. The postoperative mean uncorrected visual acuity was 20/28 and corrected visual acuity was 20/22 (P<.01). The cylindrical correction ranges from 3.7 to 6.7 with a mean of 5.3 diopters. There was progressive improvement over the first 6 months and a smaller improvement (0.75) over months 6 to 12. None of the eyes showed clinically significant haze and only 3 eyes showed minor (1/4) haze that had resolved at month 1. 3/30 eyes demonstrated an IOP spike and 13/30 eyes required more than 5 days for the epithelial defect to close (P<.1).

Conclusions:

Topo-PRK combined with Topo-CXL and oxygen supplementation appears to be relatively safe in a pilot study setting and possibly achieves a better refractive and topographic outcome than regular CXL.

Financial Disclosure:

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