PARIS — Accelerated cross-linking protocols need proper validation, and performing cross-linking in addition to LASIK is at this stage an unproven strategy, according to one specialist.
“There is no scientific background for using LASIK Xtra (Avedro) as a standard for LASIK, and it is inappropriate to widespread its use before convincing evidence has been produced,” François Malecaze, MD, said at the meeting of the French Society of Ophthalmology.
The prevalence of post-LASIK ectasia is low, roughly one in 6,000 cases with the latest technology, and a preventive treatment that modifies the cornea is not justified with such a low risk rate, he said.
The only prevention for ectasia is not to perform refractive surgery if you have any doubt, if topography shows an abnormal or thin cornea,” he said.
As far as the accelerated protocols for cross-linking are concerned, Malecaze also advocated further evaluation.
“We must go back to basic science, do proper preclinical studies ex vivo and in animals. We cannot go on to patients without this evidence,” he said.
The classic protocol of epithelium-off cross-linking with 30 minutes of riboflavin plus 30 minutes of irradiation is at present the only proven, effective treatment and the only one to propose to young patients with progressive keratoconus, he said.
Disclosure: Malecaze has no relevant financial disclosures.