ESCRS Winter Meeting

ESCRS Winter Meeting

Issue: March 2012
February 08, 2012
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Quadruple procedure halts keratoconus progression, regularizes cornea, improves vision

Issue: March 2012
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Efekan Coskunseven, MD
Efekan Coskunseven

PRAGUE — A quadruple procedure consisting of intracorneal ring implantation, corneal collagen cross-linking, phakic IOL implantation and topography-guided transepithelial PRK effectively stops keratoconus progression, regularizes the cornea and improves vision, according to one surgeon.

Efekan Coskunseven, MD, performed the quadruple procedure in four eyes of four patients.

"I performed the channels for the ICRs (Keraring, Mediphacos) with the IntraLase FS 150 femtosecond laser (Abbott Medical Optics). Depth was adjusted to 80% of the thinnest point at tunnel location," Dr. Coskunseven said at the winter meeting of the European Society of Cataract and Refractive Surgeons.

After about 1 month, cross-linking was performed. Based on the postoperative refraction obtained with the intracorneal ring and cross-linking, the power of the Visian toric ICL (STAAR Surgical) was calculated, and the lens was implanted approximately 6 months later.

"After an additional 4 months, I performed a partial topo-guided PRK of maximum 50 ?m, aiming at about 80% of the refraction," Dr. Coskunseven said.

Uncorrected visual acuity improved from counting fingers to 20/32, best corrected visual acuity improved from 20/100 to 20/32, cylinder was reduced from -5 D to -1 D, and spherical equivalent was reduced from -18 D to -1 D. Mean keratometry values decreased significantly.

  • Disclosure: Dr. Coskunseven has no relevant financial disclosures.