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First Author: FarahAbdulaliyeva AZERBAIJAN
Co Author(s): Elmar Kasimov
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To present the results topography-guided photorephractive keratectomy (PRK) with corneal collagen cross-linking (CXL) for progressive keratoconus.
: Keratoconus, Corneal collagen cross-linking, photorephractive keratectomy
Twenty-five eyes of 20 patients with progressive keratoconus underwent PRK with CXL were included. Inclusion criteria were absence of corneal scarring, corneal thickness higher than 450 mn (with minimum corneal thickness less than 400 μm after epithelial removal), and endothelial cell density more than 2700 per square millimeter. All patients underwent mechanical epithelial debridement during PRK with CXL treatment. Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (decimal scale), mean and steepest keratometric (K) values, pachymetry and topography were evaluated at baseline and at 1, 3, 6, and 12 months follow-up.
Mean baseline UCVA and BSCVA were 0.16+/-0.08 and 0.72+/-0.16, respectively; 12-month mean UCVA and BSCVA were 0.47+/-0.07 and 0.72+/-0.14, a statistically significant difference (P<0.05). Mean spherical equivalent refraction showed a significant decrease of 0.41 diopters (D). Mean baseline simulated keratometry (SIM K) flattest and steepest meridians and SIM K average were 47.10, 51.36, and 49.09 D, respectively; at 12 months, 39.22, 43.71, and 41.05 D, respectively, were recorded, a difference that was significant for all 3 indices (P<0.05). Mean baseline pupil center pachymetry decreased significantly (P<0.05) to 490.08+/-39.01 microm from baseline values of 490.68+/-30.69 microm, respectively. Endothelial cell counts did not changed significantly (P=0.13).
Topography-guided PRK combined with CXL in keratoconus, is an effective, safe, and increasingly predictable option for keratoconus. FINANCIAL INTEREST: NONE