Simultaneous Topography-guided PRK Followed by Corneal Collagen Cross-linking After Lamellar Keratoplasty for Keratoconus

Overview

Journal Clin Ophthalmol

Publisher Dove Medical Press

Specialty Ophthalmology

Date 2012 Nov 16

PMID 23152658

Citations 6

Authors

Leopoldo Spadea

Marino Paroli

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK) and prophylactic corneal collagen crosslinking (CXL) for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus.

Methods: The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK), and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50). After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization) and corneal CXL induced by riboflavin-ultraviolet A.

Results: After a mean 15 ± 6.5 (range 6-24) months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1-10). No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0) D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8-8.9) D. All the corneas remained clear (haze < 1).

Conclusion: The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.

Citing Articles

Combined corneal CXL and photorefractive keratectomy for treatment of keratoconus: a review.

Al-Mohaimeed M Int J Ophthalmol. 2019; 12(12):1929-1938.

PMID: 31850179 PMC: 6901893. DOI: 10.18240/ijo.2019.12.16.

The impact of keratoconus treatment with the Athens Protocol (partial topography-guided photorefractive keratectomy combined with higher-fluence corneal collagen cross-linking) on quality of life: a long-term study.

Kanellopoulos A Clin Ophthalmol. 2019; 13:795-803.

PMID: 31118557 PMC: 6501993. DOI: 10.2147/OPTH.S188519.

Corneal stromal demarcation line after collagen cross-linking in corneal ectatic diseases: a review of the literature.

Spadea L, Tonti E, Vingolo E Clin Ophthalmol. 2016; 10:1803-1810.

PMID: 27695286 PMC: 5034907. DOI: 10.2147/OPTH.S117372.

Current techniques of lamellar keratoplasty for keratoconus.

Spadea L, De Rosa V Saudi Med J. 2016; 37(2):127-36.

PMID: 26837393 PMC: 4800909. DOI: 10.15537/smj.2016.2.12985.

Donor cross-linking for keratoplasty: a laboratory evaluation.

Mukherjee A, Hayes S, Aslanides I, Lanchares E, Meek K Graefes Arch Clin Exp Ophthalmol. 2015; 253(12):2223-8.

PMID: 26345527 PMC: 4653237. DOI: 10.1007/s00417-015-3160-6.

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