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Combined keratoconus surgery: photorefractive keratectomy with simultaneous corneal cross-linking

Poster Details

First Author: S.Stech LITHUANIA

Co Author(s):    L. Soceviciene                    

Abstract Details


To analyze visual acuity and corneal changes after combining photorefractive keratectomy (PRK) for partial correction of refractive error using an excimer laser with simultaneous corneal Crosslinking (CXL) in patients with keratoconus, in order to improve vision and stop progression of keratoconus


Combined keratoconus surgery was performed from 2010 September to 2015 January in eye clinic Lirema in Vilnius, Lithuania


We evaluate and compare uncorrected (UDVA) and best-corrected (BCDVA) visual acuity to show change before and after half a year after the surgery. Disease stability assessed by comparing the maximum keratometry (Kmax) value after half a year and one-year after the surgery


24 keratoconus cases operated with combined surgery.Mean patients age 27.14±4.41 (20-37 years).Mean preop UDVA 0.24±0.17 (0.05 to 0.60), mean preop BCDVA 0.56±0.26 (0.05 to 1.00). Results of our analysis show statisticaly reliable improvement in both UDVA and BCDVA after half a year after the surgery: accordingly- 0.65±0.26 (0.05-1.00) and 0.80±0.17 (0.40-1.00) (p<0.001).Mean Kmax before surgery:50.41±3.08D (44.69-55.80D).Ater half a year postop Kmax decreased to 47.57D±2.58D (42.76-50.40). The comparison of the data shows Kmax decreased significantly p<0.001, cornea was flatted.We compared mean Kmax after half a year and one year postoperatively–47.57±2.58D (42.76-50.40D) and 47.58±2.39D (43.5-52.2D) (p<0.001) in 16 cases.Stable Kmax indicates unchanging corneal curvature - disease stabilization


Combined PRK with simultaneous CXL surgery stops the progression of keratoconus, saves and improves preoperative visual acuity, normalizes the central optical zone of the cornea, stabilizes the shape of the cornea resulting easier and more precise keratoconus induced refractive error correction. This procedure reduces the need for penetrating corneal transplantation. Further monitoring of keratoconus patients in order to assess the long-term effect and safety is needed

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