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Management of corneal ectasia after LASIK with combined, same-day, topography-guided partial transepithelial PRK and collagen cross-linking

Poster Details

First Author: S.Goel INDIA

Co Author(s):    S. Mukherjee   A. Shastri           

Abstract Details


To evaluate a series of patients with corneal ectasia after LASIK that underwent the Athens Protocol: combined topography-guided photorefractive keratectomy (PRK) to reduce or eliminate induced myopia and astigmatism followed by sequential, same-day ultraviolet A (UVA) corneal collagen cross-linking (CXL).


Anand Eye Hospital, Jaipur, Rajasthan.


Twelve eyes with corneal ectasia underwent transepithelial PRK immediately followed by CXL (3 mW/cm2) for 30 minutes using 0.1% topical riboflavin sodium phosphate. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent, keratometry, pachymetry, corneal topography(ATLAS Carl Zeiss) were analyzed over a period of 18 months.


9 out of 12 eyes had an improvement in UDVA and CDVA of 20/45 or better (2.25 logMAR) at last follow-up. Four eyes showed some topographic improvement but no improvement in CDVA. One of the treated eyes required a subsequent penetrating keratoplasty. Corneal haze grade 2 was present in 2 eyes.


: Combined, same-day, topography-guided PRK and CXL appeared to offer topographic stability, even after long-term follow-up. This technique may offer an alternative in the management of iatrogenic corneal ectasia. FINANCIAL INTEREST: NONE

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