Safety and efficacy of simultaneous corneal collagen cross-linking with topography-guided PRK in managing low-grade keratoconus: 1-year follow-up.

Abstract

PURPOSE:

To evaluate 1-year visual and topographic outcomes and safety and efficacy of corneal collagen cross-linking (CXL) combined with topography-guided photorefractive keratectomy (TG-PRK) to achieve near emmetropia in eyes with low-grade keratoconus.

METHODS:

Twenty-two eyes from 15 patients (11 women, 4 men) were included in a prospective, nonrandomized, noncontrolled clinical study. Mean patient age was 26.6±6.07 years (range: 19 to 40 years). Inclusion criteria were low-grade keratoconus with evidence of progression, transparent cornea, corrected distance visual acuity (CDVA) 0.8 (decimal) or better, corneal thickness >440 μm, and maximum keratometry readings (K-max) <51.00 diopters (D). All patients underwent simultaneous TG-PRK with CXL. Study parameters were uncorrected distance visual acuity, CDVA, manifest refractive error, manifest and topographic (corneal) astigmatism, patient satisfaction, and efficacy and safety of the treatment. Follow-up was 1 year.

RESULTS:

After 1 year, statistically significant improvement was noted in all study parameters (P<.01). The safety and efficacy indices were 1.6 and 0.4, respectively. Patient satisfaction questionnaire showed that 91% were satisfied, 9% were not completely satisfied but believed they improved, and none were dissatisfied. Corneal topography demonstrated significant improvement in 55%, improvement in 36%, and minor improvement in 9% of cases. No cases progressed as evidenced by keratometry readings.

CONCLUSIONS:

Simultaneous TG-PRK with CXL is an effective and safe treatment with remarkable visual and topographic outcomes in patients with low-grade keratoconus who meet the recommended inclusion criteria.

• Authors: Waleed S Tuwairqi, Mazen M Sinjab
• Journal: Journal of refractive surgery (Thorofare, N.J. : 1995) (J Refract Surg) Vol. 28 Issue 5 Pg. 341-5 (May 2012) ISSN: 1081-597X [Print] United States
• PMID: 22443804 (Publication Type: Journal Article)
• Copyright: Copyright 2012, SLACK Incorporated.

Chemical References

• Cross-Linking Reagents
• Photosensitizing Agents
• Collagen
• Riboflavin

Topics

• Adult
• Collagen (metabolism)
• Combined Modality Therapy
• Corneal Stroma (metabolism)
• Corneal Topography
• Cross-Linking Reagents (adverse effects, therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Keratoconus (drug therapy, metabolism, surgery, therapy)
• Lasers, Excimer (therapeutic use)
• Male
• Patient Satisfaction
• Photorefractive Keratectomy
• Photosensitizing Agents (adverse effects, therapeutic use)
• Prospective Studies
• Refraction, Ocular (physiology)
• Riboflavin (adverse effects, therapeutic use)
• Treatment Outcome
• Visual Acuity (physiology)
• Young Adult