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Evaluation of Scheimpflug imaging topography after corneal cross-linking and intrastromal corneal ring segmentation for keratoconus

Poster Details

First Author: M.Phylactou CYPRUS

Co Author(s):    A. Aristeidou   G. Labiris   V. Kozobolis        

Abstract Details

Purpose:

To evaluate visual acuity and analyze Scheimpflug imaging topography, in keratoconic (KC) eyes before and after corneal cross-linking (CXL) and intrastromal corneal ring segmentation (ICRS).

Setting:

Eye Institute of Thrace and Department of Ophthalmology, Medical School, Democritus University of Thrace

Methods:

Prospective observational study, in which 28 eyes, of 18 patients with progressive keratoconus were included. The 17 KC eyes underwent corneal cross-linking and the rest 11 KC eyes underwent intrastromal corneal ring segmentation. There was performed preoperative and 4±1.5 months postoperative evaluation of visual acuity and corneal topography. Measurements were associated with Scheimpflug-derived keratoconus indices, according to Pentacam manual and involving the keratoconic indices, Kmax, pachymetry thinnest location, cylinder and coma. Paired samples t-test was used to compare preoperative results with the 1st, 3rd and 6th postoperative month results.

Results:

The first group which treated with CXL, had statistically significant improvment in CDVA(0.13±0.12). Corneal topography showed statistically significant increase(p=0.043) in Kmax the 1st postoperative month and then a decrease(p=0.077) in the 3rd-6th postoperative period, the thinnest location decreased(p=0.004) in the 1st postoperative month and the KI decreased(p=0.03) in the 3rd-6th postoperative period.The second group which delivered ICRS treatment, had statistically significant improvement in UDVA(0.27±0.15). Corneal topography revealed statistically significant decrease in Kmax(p=0.089) and an increase in thinnest location(p=0.015), in the 1st postoperative month. The rest associated Scheimpflug-derived keratoconus indices had no statistically significant change in both surgical techniques.

Conclusions:

Both modern surgical treatment options for keratoconus, CXL and ICRS seem to improve the visual acuity. ICRS had better results in UCVA due to the correction of refractive errors. After CXL, the cornea thins and then recovers toward baseline thickness. There was statistically significant improvement only in 1 out of 4 topographic indices after CXL and no change after ICRS. Further follow-up and additional cases are needed in order to obtain final conclusions regarding visual acuity and associated changes in corneal topography of KC patients. FINANCIAL DISCLOUSRE: NONE

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