The Purpose Is To Develop A New Method Of Combined Treatment Of The Advanced Keratoconus, Which Includes Simultaneous Femtolaser Keratotomy With Uv-Crosslinking

The purpose is to develop a new method of combined treatment of the advanced keratoconus, which includes simultaneous femtolaser keratotomy with UV-crosslinking when it is impossible to implant corneal segments after examination data while maintaining the transparency of media in the central optical zone.

The study was carried out on the basis of S. Fyodorov Eye Microsurgery Federal State Institution using a femtosecond laser and ultraviolet light.

A femtosecond laser operation software has been developed for personalized femtolaser keratotomy according to individual calculations for each patient. UV-crosslinking is carried out simultaneously using a modified technology. Considering that we perform surgery on patients with ultra-thin corneas, deepithelialization of the central zone of the cornea is not performed. Further, after the keratotomy, we open and fill the notches with riboflavin, which ensures penetration through all layers of the cornea. Crosslinking is carried out by filling incisions with a 0.1% solution of riboflavin according to the planned technology for 30 minutes. UV-crosslinking is performed using an accelerated technique

The results of the first 5 clinical cases with a follow-up period of more than 2 years are presented. There is an increase in visual functions with the stabilization of the keratoectatic process. The proposed method makes it possible to avoid or significantly delay keratoplasty even at the advanced stages of keratoconus, when implantation of corneal segments is technically impossible. The problem requires further study.

The proposed method of surgical treatment, which allows us to operate on patients with advanced keratoconus without avoiding corneal transplantation, and which allows achieving high visual functions in the postoperative period, is certainly a promising direction in ophthalmic surgery.