ESCRS - PO0686 - Photorefractive Keratectomy For Keratoconus Treatment

Photorefractive Keratectomy For Keratoconus Treatment

Published 2023 - 41st Congress of the ESCRS

Reference: PO0686 | Type: Free paper | DOI: 10.82333/cqfs-md86

Authors: Lamari Hasnaa* 1 , Abdelfattah Benkirane 2

1Ophthalmology,clinique al bassar,mohammedia,Morocco, 2Ophthalmology,Ophtalmoclinique Casablanca,Casablanca,Morocco

Purpose

To report our results about PRK associated with cross linking in the "refractive treatment" of keratoconus.

Setting

Keratoconus affects the young patients and poses the problem of visual rehabilitation. PRK associated to cross linking is part of the therapeutic arsenal of this pathology. 

Methods

We operate 12 patients (18 eyes). Our patients were between  25 to 35 years old

The keratoconus was infraclinic or stage 1, stable and pachymétrie ≥ 450µ

The treatment included

* Topoguided trans PRK with a maximum ablation of 60µ 

* Cross Linking in the same time (10 mn of riboflavine instillation and 10 mn UV exposition)

 

 

Results

Follow up between 6 months and 5 years :

* No complications

* Visual acuity without optical correction between 5/10 and 8/10

* Post operative pachymetry : mean 398µ (340 to 400µ)

Complications : 2 cas of haze without loss of visual acuity

Conclusions

PRK in keratoconus is based on corneal topography. It's correct spherocylindrical refractive errors and normalize the corneal profile
by smoothing the corneal surface. The purpose of this treatment is 70% correction of refraction
With maximum stromal ablation from 50 to 80μ and minimum posterior wall from 350 to 400μ.
Cross linking may be conventional or accelerated, in a single operating time or sometimes before PRK in 2 operating steps with
identical end result. Many protocoles are reported : crete, athene ....

It seems a safe and effective method for "Refractive" treatment of keratoconus
It can be combined with other surgery (intracorneal rings, ICL)
The long-term evolution is unknown(Very slow stromal collagen turnover)