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5-year results of combined selective corneal wavefront-guided photorefractive keratectomy and cross-linking for progressive mild to moderate keratoconus

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Session Details

Session Title: Advanced Surface Photoablation I

Session Date/Time: Sunday 08/10/2017 | 08:00-09:30

Paper Time: 09:03

Venue: Meeting Center Room I

First Author: : S.Awwad LEBANON

Co Author(s): :    M. Ahmad   M. Abdul Fattah   V. Massoud              

Abstract Details


To evaluate the long-term efficacy and safety of combined selective corneal wavefront-guided photorefractive keratectomy (CWG-PRK) and corneal cross-linking (CXL) in progressive mild to moderate keratoconus.


American University of Beirut Medical Center


A retrospective chart review of 18 eyes of 18 patients with mild to moderate keratoconus and documented history of disease progression, having undergone combined selective CWG-PRK and CXL and mitomycin C application, with at least 5 years of regular follow up postoperatively. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent and cylinder, keratometric indices, posterior elevation, corneal higher order aberrations (HOAs), and thinnest corneal pachymetry were evaluated preoperatively and at each visit.


Mean age was 26.9 ± 10.6 years. UDVA and CDVA LogMAR improved from 0.59±0.28 to 0.40±0.26 and 0.26±0.18 to 0.11±0.08, respectively, at 5 years follow up (P<0.01). Corneal total HOAs were reduced (1.60±059 to 1.27±0.53 microns, P<0.01). Central and maximal posterior elevations remained stable over 5 years. One eye lost 1 line of CDVA due to the development of anterior stromal haze in the first postoperative months. Total mean peak ablation depth was 32.15± 7.9 μm, and the calculated residual corneal thickness was 443±24.46 μm [402-472 μm].


Combined selective CWG-PRK & CXL for selected cases of progressive mild to moderate keratoconus appears to be relatively safe and provides improved visual and refractive results with seemingly stable tomographic indices over 5 years. CWG ablation permits selective treatment of corneal higher order aberrations, thus sparing stromal tissue.

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