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Outcome of topography-guided photorefractive keratectomy with cross-linking for ectasia after laser-assisted in situ keratomileusis

Poster Details

First Author: S.Holland CANADA

Co Author(s):    D. Lin   G. Moloney   J. Tan        

Abstract Details


To evaluate early results of topography-guided photorefractive keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) for ectasia after laser assisted in situ keratomileusis (LASIK).


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55 eyes of 51 patients with contact-lens intolerant, post-LASIK ectasia were treated using Allegretto Wavelight laser (AW) TG-PRK with simultaneous CXL. Trans epithelial PRK was performed with a custom Topographical Neutralization Technique (TNT). Pre and post-operative assessment of symptoms, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction (MR) predictability, and safety were analyzed


31 of 55 eyes treated by the AW laser had sufficient data at 6 months for analysis. 18 of 31 (59%) showed UCVA ≥20/40. 20 (64%) had improved BCVA and 16 eyes (52%) gained two or more lines. No patient showed progression. Mean reduction in astigmatism (RIA) was 2.65D. All but 3 patients symptomatically improved. Complications were delayed epithelialization beyond one week in 2 patients and visually symptomatic haze in one.


Early results of TG-PRK with CXL show efficacy and safety for treatment for post-LASIK ectasia. All but 3 had improved symptoms. More than half achieved UCVA of 20/40 and also improved BSCVA. This study demonstrates an alternative treatment for highly symptomatic patients with post-LASIK ectasia with contact lens intolerance FINANCIAL INTEREST: NONE

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