Hypo-osmolar accelerated corneal crosslinking on resultant sub-400 µm topography-guided excimer regularized keratoconus corneas.
J Cataract Refract Surg
; 48(12): 1366-1374, 2022 12 01.
Article
en En
| MEDLINE
| ID: mdl-35786809
ABSTRACT
PURPOSE:
To investigate the efficacy and safety of phototherapeutic keratectomy (PTK) with topography-guided photorefractive keratectomy (T-PRK) corneal regularization followed by sequential hypo-osmolar riboflavin accelerated corneal crosslinking (CXL) in keratoconic (KC) eyes with <400 µm stromal bed thickness after excimer ablation.SETTING:
Multisurgeon multicenter standardized protocol practice.DESIGN:
Retrospective multicenter case series.METHODS:
This study included progressive KC eyes that underwent PTK and T-PRK combined with accelerated CXL and had a corneal stromal bed thickness of <400 µm after excimer ablation before administration of hypo-osmolar riboflavin. Demographics and clinical measures were reviewed at baseline and every follow-up visit.RESULTS:
61 consecutive eyes had a mean corneal stromal bed thickness of 367 ± 21 µm after excimer laser normalization. Postoperatively, uncorrected distance visual acuity (UDVA) improved by 0.29 logMAR ( P < .0001), corrected distance visual acuity (CDVA) improved by 0.07 logMAR ( P = .0012), and maximum keratometry (Kmax) decreased by 4.67 diopters ( P < .0001). The safety index was favorable (1.29 ± 0.56), with stable manifest astigmatism, Kmax, and pachymetry at 12 months. 2 eyes (3%) showed evidence of keratometric progression on topography.CONCLUSIONS:
In KC corneas thinner than 400 µm after excimer ablation, PTK epithelial removal followed by T-PRK and hypo-osmolar accelerated CXL decreases manifest astigmatism and Kmax, improves UDVA and CDVA, and halted disease progression in 97% of eyes at 12 months. These outcomes are comparable with thicker ablated corneas not requiring hypo-osmolar stromal swelling.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Astigmatismo
/
Queratectomía Fotorrefractiva
/
Queratocono
Tipo de estudio:
Clinical_trials
/
Guideline
Límite:
Humans
Idioma:
En
Revista:
J Cataract Refract Surg
Asunto de la revista:
OFTALMOLOGIA
Año:
2022
Tipo del documento:
Article