title: Accelerated versus standard corneal collagen crosslinking combined with same day phototherapeutic keratectomy and single intrastromal ring segment implantation for keratoconus.
abstract: OBJECTIVE
  To compare the results of same day transepithelial phototherapeutic keratectomy (t-PTK) and single inferior intracorneal ring segment (ICRS) combined with standard versus accelerated corneal collagen crosslinking (CXL) for keratoconus.
  
  
  METHODS
  All consecutive progressive keratoconus eyes that underwent standard or accelerated CXL treatment preceded by same day t-PTK and placement of a single inferior ICRS and had 6  and 12 months of follow-up were reviewed retrospectively. Eyes were classified into two groups, the 'standard' and the 'accelerated' group, accordingly. Visual, refractive and topographic data prior to surgery and at 6 and 12 months post-treatment were analysed.
  
  
  RESULTS
  Sixteen eyes were included in each of the standard and the accelerated groups. Mean patient age was 27.5±8.5 years and 30.5±10.7 years (p=0.38) in the standard and accelerated groups, respectively. There was a significant improvement in uncorrected distance visual acuity, refractive cylinder and all examined corneal parameters in both groups 12 months postsurgery. The corrected distance visual acuity and manifest refraction spherical equivalent showed a significant improvement after 12 months of follow-up only in the accelerated group. However, mean changes in all evaluated parameters did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  A combined treatment of accelerated CXL preceded by same day t-PTK and single ICRS is as effective as the combined treatment using standard CXL for visual rehabilitation in progressive keratoconus.
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Uri
authors.initials: U
authors.lastname: Elbaz
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Carl
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Lichtinger
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Noa Avni
authors.initials: NA
authors.lastname: Zauberman
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Yakov
authors.initials: Y
authors.lastname: Goldich
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: Setareh
authors.initials: S
authors.lastname: Ziai
authors.affiliation: Department of Ophthalmology and Vision Sciences, Yonge Eglinton Laser Eye Center, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
authors.forename: David S
authors.initials: DS
authors.lastname: Rootman
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000378:metabolism / Q000601:surgery*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D008297:Male; D018903:Photorefractive Keratectomy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D019919:Prosthesis Implantation; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen
keywords: Cornea; Treatment Surgery