Simultaneous topography-guided PRK followed by corneal collagen cross-linking for keratoconus.
OBJECTIVE
To present the results after simultaneous photorefractive keratectomy (PRK) followed by corneal collagen cross-linking (CXL) for progressive keratoconus.


METHODS
Twelve patients (14 eyes) with progressive keratoconus were prospectively treated with customized topography-guided PRK with the Pulzar Z1 (wavelength 213 nm, CustomVis) immediately followed by corneal collagen CXL with the use of riboflavin and ultraviolet A irradiation.


RESULTS
Mean follow-up was 10.69+/-5.95 months (range: 3 to 16 months). Mean preoperative spherical equivalent refraction (SE) was -3.03+/-3.23 diopters (D) and defocus was 4.67+/-3.29 D; at last follow-up SE and defocus were statistically significantly reduced to -1.29+/-2.05 D and 3.04+/-2.53 D, respectively (P<.01). Preoperative mean (logMAR) uncorrected visual acuity was 0.99+/-0.81 and best spectacle-corrected visual acuity was 0.21+/-0.19, which improved postoperatively to 0.16+/-0.15 and 0.11+/-0.15, respectively. The mean steepest keratometry was reduced from 48.20+/-3.40 D preoperatively to 45.13+/-1.80 D at last follow-up.


CONCLUSIONS
Simultaneous PRK followed by CXL seems to be a promising treatment capable of offering functional vision in patients with keratoconus.
Kymionis
George D
GD
Institute of Vision and Optics University of Crete, Greece. kymionis@med.uoc.fr
Kontadakis
Georgios A
GA
Kounis
George A
GA
Portaliou
Dimitra M
DM
Karavitaki
Alexandra E
AE
Magarakis
Michael
M
Yoo
Sonia
S
Pallikaris
Ioannis G
IG
D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003315:Cornea / Q000503:physiopathology; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D010778:Photochemotherapy / Q000379:methods*; D018903:Photorefractive Keratectomy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010865:Pilot Projects; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin