Simultaneous topography-guided partial photorefractive keratectomy and corneal collagen crosslinking for keratoconus

J Cataract Refract Surg. 2014 Sep;40(9):1430-8. doi: 10.1016/j.jcrs.2013.12.017.

Abstract

Purpose: To report the visual, refractive, and clinical outcomes of simultaneous topography-guided partial photorefractive keratectomy (PRK) and corneal collagen crosslinking (CXL) in eyes with keratoconus.

Setting: Private practice surgery center, Dubai, United Arab Emirates.

Design: Retrospective cohort study.

Methods: Refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, flat and steep keratometry (K) readings, and complications were evaluated 1, 3, 6, and 12 months postoperatively.

Results: The study enrolled 31 eyes of 31 patients aged 21 to 42 years. All study parameters showed a statistically significant improvement at 3, 6, and 12 months over baseline values. At 12 months, the mean UDVA improved to 0.23 logMAR±0.33 (SD) from 0.79±0.36 logMAR (P<.001) and the CDVA improved to 0.06±0.07 logMAR from 0.28±0.20 logMAR (P<.001). The mean defocus decreased from 3.45±1.60 diopters (D) to 1.88±1.58 D (P<.001). The flat K and steep K readings showed significant flattening. The mean refractive astigmatism decreased from -2.77±1.47 D to -0.98±0.76 D (P<.001). The improvement in study parameters plateaued after 3 months.

Conclusion: Simultaneous topography-guided partial PRK and CXL was effective, safe, and stable in keratoconus patients.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Adult
  • Collagen / metabolism*
  • Combined Modality Therapy
  • Corneal Stroma / metabolism*
  • Corneal Topography
  • Cross-Linking Reagents*
  • Humans
  • Keratoconus / drug therapy
  • Keratoconus / metabolism
  • Keratoconus / surgery
  • Keratoconus / therapy*
  • Lasers, Excimer / therapeutic use
  • Photochemotherapy / methods*
  • Photorefractive Keratectomy / methods*
  • Photosensitizing Agents / therapeutic use
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Riboflavin / therapeutic use
  • Surgery, Computer-Assisted*
  • Ultraviolet Rays
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin