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Simultaneous topography-guided Trans-PRK with corneal collagen cross-linking in management of keratoconus

Poster Details

First Author: M.Bragheeth KUWAIT

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the results of topography-guided trans-epithelial photorefractive keratectomy (TG Trans-PRK) combined with corneal collagen cross-linking (CXL) for management of eyes with low-grade keratoconus.

Setting:

A prospective, non-comparative, non-randomized, uncontrolled clinical study. New Mowasat Hospital, Al-Salamiya, Kuwait.

Methods:

Thirty two eyes of 20 patients (14 men, 6 women) were included. Mean patient age was 25.5 ± 6.5 years (range: 21 to 40 years). Inclusion criteria were low-grade keratoconus with transparent cornea, corrected distance visual acuity (CDVA) of 6/9 or better, corneal thickness ≥450 μm, and maximum keratometry readings (K-max) ≤50.00 diopters (D). All patients underwent simultaneous TG Trans-PRK with CXL. Outcomes measured were pre- and postoperative manifest refraction, spherical equivalent (SE), topographic (corneal) astigmatism, uncorrected (UCVA) and best-corrected distance visual acuity (BCVA), slit lamp evidence of corneal complications and patient satisfaction. All patients completed One year follow up.

Results:

Statistically significant improvement was noted in all study parameters (P<0.01). At one year follow up 87.5% of the eyes were within ± 1.00 D SE. The mean UCVA improved from 6/60 preoperatively to 6/9 postoperatively. The average gain in lines for UCVA was 5.35. Patient satisfaction questionnaire showed that 75% were satisfied, 25% were not completely satisfied but believed they improved, and none were upset. Corneal topography demonstrated significant improvement in all cases. No cases had postoperative keratoconus progression as evidenced by keratometric readings. Twelve eyes (37.5%) developed mild corneal haze which has completely resolved by the third postoperative month.

Conclusions:

Simultaneous TG Trans-PRK with CXL is an effective, safe and a good option to improve vision, reduce corneal astigmatism and stabilize corneas in patients with low-grade keratoconus.

Financial Disclosure:

NONE

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