title: Corneal Collagen Crosslinking for Post-LASIK Ectasia: An Australian Study.
abstract: OBJECTIVE
  Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting.
  
  
  METHODS
  Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia.
  
  
  METHODS
  Eleven patients (14 eyes; mean age, 39.7 ± 12.6 years) underwent epithelium-off CXL with follow-up ranging from 12-78 months. Best spectacle-corrected visual acuity (BSCVA), simulated keratometry, corneal topography indices, and higher-order aberrations (HOAs) [mean ± standard error of the mean (SEM)] were measured with a rotating Scheimpflug camera (Pentacam, Oculus). Comparisons between baseline measurements and postoperative outcomes were performed using paired t test analysis.
  
  
  RESULTS
  At last follow-up, BSCVA improved significantly by 0.2 ± 0.06 logMAR (P = 0.01), and 12 of 14 eyes showed no keratometric deterioration. Of the corneal topography indices, index of height asymmetry showed a trend toward a significant improvement (P = 0.05). There was no progression of corneal HOAs. Central corneal thickness was not significantly altered (P = 0.6). No major postoperative complications were observed.
  
  
  CONCLUSIONS
  In the Australian setting, CXL has proven effective at stabilizing the progression of post-LASIK ectasia, inducing corneal regularity, and improving visual acuity.
authors.affiliation: Sydney Cornea Clinic, Sydney, Australia.|Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
authors.forename: Jessica Y
authors.initials: JY
authors.lastname: Tong
authors.affiliation: Sydney Cornea Clinic, Sydney, Australia.|Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
authors.forename: Deepa
authors.initials: D
authors.lastname: Viswanathan
authors.affiliation: Vision Eye Institute, Chatswood, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hodge
authors.affiliation: Vision Eye Institute, Chatswood, Australia.|Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, Australia.
authors.forename: Gerard
authors.initials: G
authors.lastname: Sutton
authors.affiliation: Vision Eye Institute, Chatswood, Australia.
authors.forename: Colin
authors.initials: C
authors.lastname: Chan
authors.affiliation: Sydney Cornea Clinic, Sydney, Australia.|Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.|Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, Australia.|South West Vision Institute, Liverpool, New South Wales, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: Males
mesh_terms: D000328:Adult; D003094:Collagen / Q000627:therapeutic use*; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D003316:Corneal Diseases / Q000188:drug therapy* / Q000473:pathology; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D011184:Postoperative Period; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen
keywords:  refractive surgery; LASIK; crosslinking; ectasia