title: Superficial corneal crosslinking during laser in situ keratomileusis.
abstract: OBJECTIVE
  To determine the safety of superficial corneal crosslinking after laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Institut für Refraktive und Ophthalmo-Chirurgie, Zurich, Switzerland.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Eyes with an ectasia risk score of 2 or higher were treated with standard LASIK (90 μm flap) for myopia correction, after which a rapid corneal crosslinking was performed in the interface (riboflavin 0.5% for 2 minutes, 9 mW/cm(2) for 5 minutes) (Group 1). The follow-up was up to 1 year. The prevalence of complications was statistically compared with that in a group of eyes matched regarding age, sex, and attempted refractive correction that were treated with standard LASIK only (Group 2).
  
  
  RESULTS
  One month postoperatively, 5 eyes in Group 1 lost 1 line of corrected distance visual acuity (CDVA) compared with 1 eye in Group 2 (P < .05). One year postoperatively, all eyes regained their preoperative CDVA, indicating a complication rate of less than 5%. The refractive success was identical in both groups. Early postoperative complications such as erosions (16%), diffuse lamellar keratitis (DLK) stage 1 (38%), and DLK stage 2 (5%) were statistically significantly more frequent after superficial corneal crosslinking, leading to a statistically significantly reduced uncorrected distance visual acuity at 1 month (P < .001).
  
  
  CONCLUSIONS
  Based on 1-year results, superficial corneal crosslinking might be considered a safe adjunct to LASIK, with a delayed visual rehabilitation and a higher prevalence of transient side effects. It is not proved whether superficial corneal crosslinking can prevent iatrogenic keratectasia.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Institut für Refraktive und Ophthalmo-Chirurgie (T.G. Seiler, Fischinger, Koller, Derhartunian, T. Seiler), Zürich, Switzerland and the Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar (T.G. Seiler, Fischinger), Technische Universität München, München, Germany. Electronic address: theo@seiler.tv.
authors.forename: Theo G
authors.initials: TG
authors.lastname: Seiler
authors.affiliation: From the Institut für Refraktive und Ophthalmo-Chirurgie (T.G. Seiler, Fischinger, Koller, Derhartunian, T. Seiler), Zürich, Switzerland and the Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar (T.G. Seiler, Fischinger), Technische Universität München, München, Germany.
authors.forename: Isaak
authors.initials: I
authors.lastname: Fischinger
authors.affiliation: From the Institut für Refraktive und Ophthalmo-Chirurgie (T.G. Seiler, Fischinger, Koller, Derhartunian, T. Seiler), Zürich, Switzerland and the Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar (T.G. Seiler, Fischinger), Technische Universität München, München, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Koller
authors.affiliation: From the Institut für Refraktive und Ophthalmo-Chirurgie (T.G. Seiler, Fischinger, Koller, Derhartunian, T. Seiler), Zürich, Switzerland and the Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar (T.G. Seiler, Fischinger), Technische Universität München, München, Germany.
authors.forename: Viktor
authors.initials: V
authors.lastname: Derhartunian
authors.affiliation: From the Institut für Refraktive und Ophthalmo-Chirurgie (T.G. Seiler, Fischinger, Koller, Derhartunian, T. Seiler), Zürich, Switzerland and the Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar (T.G. Seiler, Fischinger), Technische Universität München, München, Germany.
authors.forename: Theo
authors.initials: T
authors.lastname: Seiler
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000378:metabolism; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014065:Tonometry, Ocular; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin