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First Author: M.Grentzelos GREECE
Co Author(s): G. Kymionis A. Plaka K. Tsoulnaras I. Pallikaris
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To present the results after simultaneous transepithelial phototherapeutic keratectomy (t-PTK) combined with conventional photorefractive keratectomy (PRK) followed by corneal collagen crosslinking (CXL) for pellucid marginal corneal degeneration (PMD).
Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
In this prospective, interventional case series, six patients (eight eyes) with progressive PMD were enrolled. All patients underwent simultaneous t-PTK combined with conventional PRK immediately followed by CXL. Visual and refractive outcomes were evaluated along with endothelial cell density (ECD) preoperatively and at 1, 3, 6, and 12 months postoperatively.
No intraoperative or postoperative complications were observed in any of the patients. Logarithm of the minimum angle of resolution (LogMAR) mean uncorrected distance visual acuity (UDVA) improved significantly from 1.05 ±0.33 preoperatively to 0.41 ±0.27 (p=0.018) at 12 months postoperatively. Mean corrected distance visual acuity (CDVA) did not change significantly (p<0.05) at 12 months postoperatively. Mean preoperative spherical equivalent refraction improved significantly from -3.52 ±2.29 diopters (D) preoperatively to -1.57 ±1.76 D (p=0.028) at last follow-up. Mean corneal astigmatism was significantly reduced from 6.83 ±2.33 D preoperatively to 4.71 ±1.89 D (p=0.018) at last follow-up. Mean steep keratometry was significantly reduced from 48.28 ±3.04 D to 45.38 ±2.00 D (p=0.018) at last follow-up; mean flat keratometry did not change significantly (p>0.05) at 12 months postoperatively. No ECD alterations were observed throughout the follow-up period (p>0.05).
Simultaneous t-PTK combined with conventional PRK followed by CXL seems to be an effective and promising combined treatment for the management of patients with PMD.