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Peculiarities of the postoperative period of the photorefractive keratectomy with simultaneous cross-linking for keratoconus

Poster Details

First Author: I.Vasilieva RUSSIA

Co Author(s):    V. Egorov   O. Tatanova           

Abstract Details

Purpose:

To analyze the visual acuity, keratopachimetry data and features of the healing of the cornea after photorefractive keratectomy (PRK) with simultaneous crosslinking of the corneal collagen in patients with keratoconus

Setting:

PRK and cross-linking were performed simultaneously in 2 eyes of 2 patients (women of 24 and 28 years) with slowly progressive keratoconus of the I stage. According to keratotopography there was a central variant of keratoconus. The maximum refraction of the cornea by the keratotopogramme was 52 and 49 D.

Methods:

Transepithelial PRK was performed on excimer laser installation “Microscan Vizum” (“Optosystems”, Russia). Planned residual corneal thickness was not less than 400 microns. Crosslinking was performed immediately after PRK on a standard protocol for 30 minutes using the “UFA-Link” (Russia) with the drug “Dekstralink” (riboflavin-mononucleotide 0.1% and dextran 20%). Standard ophthalmic examination conducted prior to surgery, at 3rd and 6th months after surgery included visometry, biomicroscopy, keratopachimetry and keratotopography (“Pentacam” Oculus, Germany). Preoperatively uncorrected visual acuity (UVA): 0.05 and 0.2; corrected visual acuity (CVA) – 0.5 and 0.6, minimum keratopachimetry – 487 and 503 microns.

Results:

Corneal epithelialization ended in 5-6 days. However, local swelling of the epithelium and corneal stroma in an optical zone maintained for 3-3.5 months after surgery. UVA was 0.05 and 0.1, and CVA – 0.2 and 0.3. Corneal thickness – 365 and 395 microns. After 6 months (resolvent and trophic instillations): regression of corneal edema, increasing of UVA to 0.5 and 0.6, CVA – to 0.6 and 0.8. The thickness of cornea – 394 and 412 microns. Biomicroscopic noted slight subepithelial corneal opacity. Refractive results were consistent with planned. Maximum ophthalmometry on keratototopogramme was 46 and 48 D.

Conclusions:

At the photorefractive keratectomy with simultaneous crosslinking in patients with 1st stage of central type keratoconus in 6 months after surgery was a significant increase of UVA on 0,4 and 0,55 and of CVA on 0.1 and 0.2. At the same time, it should be noted lengthy recovery period associated with the postoperative keratopathy requiring monitoring and corrective treatment. FINANCIAL DISCLOUSRE: NONE

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