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First Author: S.Anisimov RUSSIA
Co Author(s): S. Anisimova K. Zolotorevskiy
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To evaluate the changes in visual acuity in patients with keratoconus and keratoectazia after the personalized crosslinking.
For the irradiation stage of crosslinking "Apparatus for phototherapy of the cornea" ("Transkontakt ltd.", Russia) was used. Individual masks were printed on the cutting plotter (GraftRobo, Japan). Visual acuity was assessed before surgery, after 2 weeks, 3 months and 6 months after surgery. Objectively, the effect of the operation was controlled by keratotopograph ḋOrbscan IIṠ, (Germany)
Studies were performed on 118 eyes of 59 patients, 36 men (61%), 23 women (39%). The average age of patients was 22-35 years. All of the patients were operated with local anesthezia procedure performed on crosslinking Zurich protocols, for 25 patients (42%) it was completed a routine procedure of crosslinking method - the control group; for 34 (58%) -personalized crosslinking - the main group.
In control group after routine procedure the sedation of the operated eye tissue occurred in 10-14 days. However, after 2 weeks after surgery visual acuity decreased by 1-3 lines maximum. We have linked this pattern with the emergency of early stromal opacities. At the same time after 3 months maximum visual acuity increased by 1-3 lines from baseline and remained stable during the entire period of observation. In patients of primary group the epithelialisation was completed to 5-7 day. It should be noted that maximum visual acuity in patients, operated by a personalized crosslinking, varied depending on the location of ectazia. Thus in the case of ectazia localization in the central optical zone maximum visual acuity decreased by a line or stayed the same 2 weeks after surgery. After 3 months maximum visual acuity increased by 2-3 lines from baseline. In the case of ectazia localization in the paracentral area maximum visual acuity in these patients did not change or increased by 1 line 2 weeks after surgery. After 3 months maximum visual acuity increased by 2-4 lines and remained unchanged throughout the whole follow-up period. In none of the clinical cases we found deterioration in visual acuity
Personalized crosslinkig is less invasive method in comparison with classic crosslinkig. After these operations visual acuity increased in all patients we have observed. In the early postoperative period it is possible to control the curvature only of the anterior corneal surface using optical topography. Other parameters are grossly distorted due to the lack of reliable signal reflects of distribution of the values of corneal thickness.