title: New microwave thermokeratoplasty and accelerated crosslinking method for keratoconus: results in 24 eyes during a 1-year follow-up.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of a new microwave thermokeratoplasty procedure combined with accelerated corneal collagen crosslinking (CXL) to improve visual function in patients with keratoconus.
  
  
  METHODS
  Cornea and refractive surgery department, Istanbul, Turkey.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Patients with keratoconus who had the combined procedure were evaluated over 12 months postoperatively. The main outcome measures were changes in logMAR uncorrected (UDVA) and corrected (CDVA) distance visual acuities and in keratometry (K) values.
  
  
  RESULTS
  The study enrolled 24 eyes of 24 patients aged 18 to 45 years. The attempted corrections ranged from -1.60 to -6.50 diopters (D). The mean preoperative UDVA of 0.66 logMAR ± 0.26 (SD) significantly improved to 0.39 ± 0.21 logMAR 1 month postoperatively. However by 6 months, the mean UDVA had regressed to 0.58 ± 0.21 logMAR. At 12 months, the mean UDVA was 0.62 ± 0.17 logMAR. The mean K value was 49.11 ± 2.43 D preoperatively, 43.50 ± 3.04 D 1 month postoperatively, 47.52 ± 2.99 D at 6 months, and 48.37 ± 3.00 D at 12 months. There were no cases of significant endothelial cell loss or loss of CDVA lines at 12 months.
  
  
  CONCLUSIONS
  The new thermokeratoplasty procedure followed by accelerated CXL produced the desired reduction in K values and improvement in postoperative UDVA without significant side effects. However, the early and complete regression of the thermokeratoplasty effect shows the need for further advancement of this technology.
  
  
  BACKGROUND
  Drs. Yilmaz and Marshall are paid consultants to Avedro, Inc. Dr. Muller is president and CEO of Avedro. No other author has a financial or proprietary interest in any material or method mentioned.
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom. Electronic address: h.ugurcelik@gmail.com.
authors: Ugur
authors: U
authors: Celik
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: Nese
authors: N
authors: Alagoz
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: Yusuf
authors: Y
authors: Yildirim
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: David
authors: D
authors: Muller
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: John
authors: J
authors: Marshall
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: Ahmet
authors: A
authors: Demirok
authors: From Beyoglu Eye Training and Research Hospital (Celik, Alagoz, Yildirim, Yilmaz) and the Department of Ophthalmology (Demirok), Medeniyet University, Istanbul, Turkey; Avedro (Muller), Boston, Massachusetts, USA; the Institute of Ophthalmology (Marshall), London, United Kingdom.
authors: Omer Faruk
authors: OF
authors: Yilmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D055954:Corneal Endothelial Cell Loss; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D003972:Diathermy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D008872:Microwaves; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin