Three year results after femtosecond laser-assisted circular keratotomy as a treatment for keratoconus stage I-II: comparison with (iontophoresis-assisted) corneal cross-linking

Session Details

Session Title: Presented Poster Session: Refractive

Venue: Poster Village: Pod 3

First Author: : D.Breyer GERMANY

Co Author(s): :    H. Kaymak   K. Klabe   P. Hagen   T. Ax   F. Kretz   G. Auffarth        

Abstract Details

Purpose:

Circular keratotomy (CKT) represents an effective treatment of the progression of keratoconus. Recently, we refined the CKT by replacing the trephine cut technique by a femtosecond laser-induced intracorneal cut (FSCKT), rendering sutures unnecessary. The aim of this analysis is to address the question, whether FSCKT is as effective in halting progression of keratoconus of stage I and II as (Iontophoresis-Assisted) Corneal Cross-Linking ((I)CXL).

Setting:

All FSCKT (Femto LDV, Ziemer) and (I)CXL treatments and follow-ups were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany.

Methods:

In this study, 10, 114 and 38 eyes were treated with FSCKT, CXL, and ICXL, respectively. Follow up measurements were performed at 6 months, 1 year, 3 years, and 5 years. Manifest refraction and corrected monocular visual acuity at far (CDVA) were measured with a phoropter and EDTRS reading charts. Keratometry and pachymetry readings as well as Belin/Ambrósio Enhanced Ectasia data (BAD-D) was assessed via Scheimpflug tomography (Pentacam, Oculus).

Results:

In 9 of 10 eyes treated with FSCKT, no signs of a progressing keratoconus were found. The mean values for CDVA, corneal thickness at the thinnest point CTTP, maximum keratometry Kmax and BAD-D remained stable within the 3-year follow up. CDVA was 0.00+-0.09 logMAR 3 years after surgery. However, 1 eye (10%) initially treated with FSCKT displayed progressing keratoconus and was retreated with CXL. In the CXL-group, mean values for CDVA, CTTP, Kmax and BAD-D also remained stable or even improved, whereas our first results for ICXL display a trend towards small but continued progression.

Conclusions:

So far, our 3-year results indicate that FSCKT is effective in stopping the progression of keratoconus of stage I and II. Our first results for ICXL indicate that this treatment option might be a suitable alternative to CXL only for early stages of keratoconus.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a competing company