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Initial results of simultaneous topoguided surface ablation and AVEDRO accelerated corneal cross-linking (ACXL) for treatment of mild to moderate cases of keratoconus

Poster Details

First Author: M.Wagih El-Deeb KUWAIT

Co Author(s):                  

Abstract Details


Corneal collagen cross linking since was introduced 10 years ago is now considered one of the effective procedures to strengthen the structural integrity of the weak cornea. Accelerated CXL is now adding more value in halting the progression of ecstatic cornea. Many strategies have been suggested to create an ideal smooth surface before CXL. In that study, limited Topguided PRK before ACXL had enhanced the visual (BCVA) and refractive (K-readings) outcomes.


New Dar Al-Shifa Hospital, Kuwait


A prospective study of 24 eyes of 16 patients having mild to moderate stable KC for 6-12 months. Topoguided PRK using Amoils epithelial scrubber with an average ablation depth 48 µ was performed. Then we put 3 applications of VIBX drops (Riboflavin 0.1% in Dextran 20%), 2 min each. Rinsing the cornea with BSS for 30 sec. then followed by application of the UVR (30 mW/cm2) for 3 min time. Application of MMC 0.02% for 20 sec. Proper washing by chilled 4 C? BSS before BCL application for 5-7 days.


Initial visual and refractive outcomes were estimated preoperatively and compared to 1, 3, and 6 months postoperatively. - Mean preoperative BCVA is 20/80, mean preoperative K-readings is 48.85, and mean preoperative pachemetry is 482 µ. - Mean BCVA was 20/60 at 1st & 3rd month and 20/40 at 6th postoperative month respectively.17 eyes had got better one or two more line(s) of BCVA, and the other 7 remained unchanged. - Mean k-readings were 46.58, 45.92 and 44.73 at 1st, 3rd and 6th postoperative months respectively. - Mean pachymetry was 454 µ, 492 µ and 501 µ at 1st, 3rd and 6th postoperative months respectively.


Accelerated CXL has a comprehensive stability of the ectatic cornea that definitely freezes KC progression. Limited topoguided surface treatment has also a smoothening effect which helps to improve the patient’s BCVA. Combined simultaneous surface ablation followed by cross linking (Sim LCXL) is a very relative convenient therapeutic modality for corneal ecstatic lesions (Treatment for diseases that have NO other treatment). FINANCIAL DISCLOSURE?: No

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