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Topography-guided photorefractive keratectomy and cross-linking for ectasia after laser assisted in situ keratomileusis

Session Details

Session Title: Keratoconus and ectasia

Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00

Paper Time: 17:27

Venue: Elicium 2 (First Floor)

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).


Laser Eye Centre


37 eyes of 26 patients with post-LASIK ectasia were treated using Allegretto Wavelight laser (AW) TG-PRK with simultaneous CXL. Trans epithelial PRK was performed with 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.


18 of 37 eyes treated by the AW laser had sufficient data at 12 months for analysis. 11 of 18 (61%) showed UCVA ?20/40. 8 eyes (44%) gained two or more lines of BSCVA while 1 (6%) lost two or more lines. Mean reduction in astigmatism (RIA) was 2.52D. All but 3 patients symptomatically improved.


Early results of custom TG-PRK with CXL shows promise as an effective and safe treatment for post-LASIK ectasia All but 3 patients had improved symptoms. More than half of the eyes treated recovered 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, potentially avoiding a corneal transplant.

Financial Interest:


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