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First Author: A.Doga RUSSIA
Co Author(s): E. Branchevskaya S. Izmaylova Y. Kishkin
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To explore the use of the MicroScan Visum eximer laser (Optosystems, Troitsk, Russia) in topography-guided PRK performed after collagen cross-linking (CXL) in keratoconus patients
S. Fyodorov Eye Microsurgery State Institution
Prospective, non-comparative analysis of 27 cases (27 eyes of keratoconus patients). All patients underwent CXL procedure using 0.1% riboflavin and 20% dextran solution and UV-X 1000 illumination system (IROC AG, Zurich, Switzerland). Inclusion criteria for topography- guided PRK were at least 6 months of stable refraction after CXL procedure, corneal thickness more than 450?m pre op. Assumed ablation depth was 50?m. Ablation zone varied depending on pupil size and attempted correction. An ablation profile based on corneal topography data and manifest refraction data and was created using KeraScan software. Transepithelial PRK was performed using MicroScan Visum eximer laser. Postoperative assessments (BCVA, UCVA, corneal topography) were performed at 1 week and 1, 3, 6 and 12 months.
Mean attempted spherical equivalent (SE) refraction was 3.8ḟ0.49 D. Mean attempted myopic cylinder correction was 4.3ḟ0.74. Median preoperative BCVA was 0.5 and median preoperative UCVA was 0.2. Efficacy: 74% of eyes achieved UCVA 0.5. 67% achieved BCVA 0.7 and more. Safety: no eyes have lost lines of BCVA. 44,4% of eyes gained 4 lines of UCVA, 59% gained 2 lines or more. There was a statistically significant decrease of surface asymmetry and surface irregularity indexes.
Topography-guided PRK performed with MicroScan Visum excimer laser appears to be effective for irregular astigmastism correction after CXL in keratoconus patients.