- Journal of Refractive Surgery
- February 2010 - Volume 26 · Issue 2: 145-152
To evaluate a combination of topography-guided custom ablation and corneal collagen cross-linking (CXL) in a single procedure for the treatment of keratectasia.
Twelve eyes of 12 patients with keratectasia were treated with topography-guided custom ablation and CXL. Topography-guided custom ablation was performed using a transepithelial technique with the iVIS Suite 1 kHz flying spot excimer laser. Collagen cross-linking was performed immediately after topography-guided custom ablation, according to standard protocol. Postoperative follow-up examinations were performed at 1, 3, 6, and 12 months. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive change, corneal topography, and pachymetry were analyzed pre- and postoperatively.
Mean UCVA increased from 20/1000 preoperatively to 20/125 12 months postoperatively. Mean BSCVA increased from 20/57 to 20/35, with no loss of lines of visual acuity. Mean astigmatism was reduced from 5.40±2.13 diopters (D) to 2.70±1.44 D, and keratometric asymmetry decreased from 6.38±1.02 D to 2.76±0.73 D. Only minor changes in posterior corneal surface elevation and stability of refraction were found, confirming that no progression of ectasia occurred during the observation time.
A combination of topography-guided custom ablation and CXL improved patients’ visual, refractive, and topography outcomes and halted the progression of keratectasia within the observation period of 12 months. This method may postpone or eliminate the need for corneal transplantation in suitable cases with keratectasia.
From the Eye Department, University Hospital of North Norway and SynsLaser Kirurgi AS, Tromsø, Norway (Stojanovic); School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China (Zhang, X. Chen, S. Chen, Wang); and Øyelegesenteret, Tromsø, Norway (Nitter).
Financial support provided by SynsLaser Kirurgi AS, Tromsø, Norway.
The authors have no financial interest in the materials presented herein.
Correspondence: Aleksandar Stojanovic, MD, University Hospital North Norway, 9038 Tromsø, Norway. Tel: 47 90693319; Fax: 47 77647929; E-mail: firstname.lastname@example.org